One of the biggest drivers of physician burnout are the clerical burdens that gobble up more than half of doctors’ days—and many nights and weekends to boot. Perhaps the most galling part is that a notable chunk of these burdens are based on outright myths, misconceptions and misapplications of the morass of complicated regulations that govern American health care.
That is where the AMA’s “Debunking Regulatory Myths” series comes in to provide clarity to physicians and their care teams. The series is part of the AMA’s practice-transformation efforts and helps reduce guesswork and administrative burdens so physicians’ focus can be on streamlining clinical workflow processes, improving patient outcomes and increasing satisfaction.
As the leader in physician well-being, the AMA is reducing physician burnout by removing administrative burdens and providing real-world solutions to help doctors rediscover the Joy in Medicine™.
So far, the AMA has set the record straight on nearly 30 regulatory myths, including these 10 below. Explore further to learn whether your practice, hospital or health system can find some new ways to save physicians’ time while staying on the regulatory straight and narrow.
Does CMS say that note templates are a no-go?
In an era of unending clerical work, using note templates to complete documentation can be a great way for a physician to cut down on the busywork and free up more time to spend caring for patients.
But some physician practice and health care organization leaders believe that documentation requirements from the Centers for Medicare & Medicaid Services (CMS) bar physicians from using note templates. In fact, the government has no rules that stop physicians from using templates to help them document medical information tied to patient encounters.
Do medical boards have to probe doctors’ mental health history?
Physicians and other health professionals filling out applications often encounter questions from medical licensing boards, credentialing bodies and professional liability insurance carriers about any past history of mental illness or substance-use disorder.
It turns out that The Joint Commission—which accredits hospitals and other health care organizations—the Federation of State Medical Boards does not require that states, hospitals, insurers or others ask about this history. Along with the AMA. other organizations that support not asking for this information include the American Psychiatric Association, American College of Physicians, and American College of Emergency Physicians.
Drop the pen. Doctors don’t have to sign every page of a home care plan.
Physicians often hear conflicting instructions on how they should sign a home health agency plan of care certification or recertification, sometimes being told they need to sign and date every single page of the document. But does CMS really require physicians to take the time to go to those administrative lengths? The short answer is no.
Yes, other team members can respond to patient portal messages
In-basket patient messages rose by 57% from 2019 to 2020, according to research published in the Journal of the American Medical Informatics Association. And the average time spent per patient portal message is 2.32 minutes, with an active, busy doctor getting 20–40 of these messages daily.
So: Are physicians the only ones allowed to respond to those emails? Some health care organizations may have rules that say that, but there is no federal regulation stating that only physicians can respond to patient portal messages.
No, hospitals don’t have to send event notifications to doctors’ inbox
Physicians are familiar with the inbox influx: A host of messages from hospitals or other health care entities where their patients received care. Often the messages are redundant or have incomplete information. Many believe that Medicare-participating hospitals are required to deliver electronic patient event notifications directly to a physician’s EHR inbox—but that’s just a myth.
Are you required ask about patients' pain at every consult?
No, The Joint Commission does not require physicians to ask every patient about their pain at every visit. An earlier requirement that “pain be addressed in all patients” was rescinded in 2009 from all programs except behavioral health.
Yes, you can bill E/M and preventive care from the same visit
Despite myths to the contrary, physicians are not prohibited from coding and billing for both preventive and problem-focused evaluation and management (E/M) services when they are performed during the same appointment.
Speak up, because verbal orders are not prohibited in health care
Some physicians and health systems operate under the assumption that federal health care policy and regulatory agency rules prohibit them from giving verbal orders. However, to the AMA’s knowledge, CMS and The Joint Commission do not prohibit verbal orders from being used.
No, teaching doctors do not need to redocument student EHR work
Historically, teaching physicians were required to redocument medical students’ entries in a patient’s electronic health record. But they don’t have to do that anymore.
Is chronic care management consent required regularly?
There are some physicians who believe that the CMS requires them to obtain patient consent at regular intervals to continue to bill for ongoing chronic care management services. But it is a myth. The truth is that CMS does not require physicians, other health professionals or health care organizations to obtain patient consent for chronic care management that is done on a regular, recurring schedule.
Delve even further with the complete list of AMA-debunked regulatory myths.
Also, find out more with the “AMA Debunking Medical Practice Regulatory Myths Learning Series,” which is available on AMA Ed Hub™ and provides regulatory clarification to physicians and their care teams. For each topic completed, a physician can receive CME for a maximum of 0.25 AMA PRA Category 1 Credit™.
Physicians can submit a medical regulatory myth you’d like clarification on from the AMA. The team will do research to clarify the matter. If something turns out not to be a myth and really is a regulation that puts unnecessary burden on physicians and their teams, the AMA’s advocacy arm can get involved to push for regulatory change.
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