No doctor has time to read all of these papers. They all rummage through it and sign wherever the signature needs to go. After all there are atleast 100 or more signatures to be done everyday for which there is no compensation.

Among these papers are those sent by some shady vendors and companies. Here are few examples of those:

1) Diabetic Supplies:Diabetic Supply is a big business. That is why you hear those ads about free diabetic supply delivered to your door. Automatically! It is not that automatic. Once the patient requests diabetic supply from the company, they will send a form to the physician to sign. This form has the diagnosis codes and frequency of use, which is usually already filled out by the company salesmen. What they won’t tell you is that they documented the patient needs to check his or her sugar 5 times a day. Even when they are not on insulin. If you sign this form without correcting it, they will send the patient enough supply so they can check their sugars five time a day. This is called Upselling – Selling more than what someone needs. If Medicare comes after them, they have a good defence – “the doctor told us to do that!”

The doctor did not even have the time to read the form thoroughly and gets dinged for overutilization of medicare resources!!

2) Motorized Wheelchair and Scooters: You get these prefilled forms that patient needs a scooter. He may not need it. He probably will do fine with a manual wheel chair. But those sell cheap. So these wheelchair dealers will try to get you to sign a motorized wheel chair for the patient. If Medicare audits, then your neck is on the line.

3) Change Meds to Generic and save $$$: But they won’t tell who saves the dollars. The company or the patient. The patient many a times still pays the same. But if you sign it thinking patient would not mind saving this money, you will be in for a surprise. The Pharmacy will turn around and tell the patient that the doctor asked us to change it. The patients will be angry that they were not consulted before doing so.

4) Refill these prescriptions: Patients who have not followed up with you in a year may go to the pharmacy to see if they can get their meds. The pharmacist will send you a fax. Sign it for refills for next few months will increase your liability as you are now responsible for the side effects of the meds if not monitored. If such a request comes in just give out enough pills to give the patient time to et to your office. Definitely NO REFILLS!

Moral of the story: No one can read everything. But know what to check for each document before you sign it.

Since Childhood, everybody has chased the dream of having the workload lighten up once the education part of life is over. Same goes with medicine. Once into Medical School, we realize the amount of work we have to put in it. Every day Medical Students slog through various rotations, schedules, USMLE, reports etc. This list goes on. 

Once the medical school is over, getting into internship is a shocker. If you thought medical school was tough, then you have no idea what an internship would be like. Once the internship is over, the pressure does ease off in the later years of residency but not significantly. There is always more to do and learn.

So for those who wonder if being an attending physician is easier than residency or not, then the answer is NOT. The workload of an attending physician is similar to or worse than that of medical interns. But there are some good differences:

1) The scutwork and running around is reduced.

2) Number of patients the attending physicians take care of  are higher, but then their schedule is not interrupted by conferences and classrooms.

3) With experience, the medical decision making becomes easier and attending physicians do not have to refer to clinical data and research too often.

4) Compensation improves and takes the brunt away from hard work. 

So there is more mental work than physical work after becoming an attending physician, which is a blessing. But it is still hard work and for most of us. There is more responsibility, more rewards. How hard did you expect to work after medical residency?