Correspondence (Winter 2001)

AMA CPT Code Shenanigans

Dear Editor,

What bothers me in Drs. Cihak and Glueck's August 14, 2001 article on WorldNetDaily is the implication CPT codes should be free to the doctors. This seems to say we approve of coding. I certainly do not. They are the bane of our existence forcing us to waste hours searching for numbers and letters and modifications to fit some idiotic aspect of a disease. Have you noticed how often disease fails to comply with our observation forcing us to bend numbers in order to justify some insurance eyes looking at us?

We need to do away with CPT coding entirely. It is unscientific. It skews rather than improves precision in defining disease. It subjects us to arrest and confinement.

A mistake in coding is fraud. We do not need that. The Gestapo should have died with Hitler and his gang and the Gang of Four in China. Factually, it thrives everywhere.

Physicians need help to improve and maintain their medical competency, not forced to hone their CPT coding. This enriches the AMA while we idle away at defining non-scientific words and processes.

The AMA needs to realign its mission to the medical profession. We are not lackeys of the politicians and the insurance industry. We are brethren who have been badly hurt in the most rotten silent power struggle ever seen, positioned for punishment rather than helped by the AMA. Its sins to its constituency are horrid.

The other option is to argue for freedom rather than for free CPT coding. We cannot go on in the hostile environment that stifles the average doctor, making every day one of fear and loathing rather than one of grace and enlightenment. We need to stop being forced to please some insurance Inspector General. This stretches the truth for monetary gain. That is not what our life's work should be?

The scouring eyes of the evil statist politicians need to look at themselves. They need to clean their own house. Physicians are hard enough on one another in the best of circumstances. We clean our own house very well.

A.W. Orlandella, MD
Laguna Beach, CA


Dear Senator Lott,

I applaud your efforts on behalf of physicians and health care consumers throughout the nation regarding the AMA's monopoly on CPT codes. I urge you to remain courageous and stalwart in your efforts. There is no question the AMA has not acted in anyone's best interest but their own in order to increase profits. The codes should be free to all as any government required form is --- i.e., IRS forms. We physicians need to be freed from bureaucratic constraints so we can efficiently deliver the best health care in the world. Your help in the dissolution of this AMA-government cartel will do more for the future improvement of the health care system in this country than any Patients' Bill of Rights. It may even be the catalyst for the kind of revolutionary change the system needs to make health care more available to all and to make it less hurtful to those of us who provide it. Thank you and good luck.

Richard J. Lewis, DO, FACOG
Wall, NJ

The AMA, Boy Scouts and Homosexuality

Dear Editor,

The Boy Scouts of America take their mission seriously. They believe that boys should be given positive role models in the adult community and that they should engage in numerous positive, civic and philanthropic activities. According to their mission and as part of their effort in providing positive, wholesome activities, the Boy Scouts banned homosexuals, particularly scoutmasters from their organization. Amazingly, this action was fought all the way up to the U.S. Supreme Court. In a June 28, 2000 decision, the court ruled that Boy Scouts had a constitutionally protected right to "expressive associations" and that as a private organization it could not be forced to accept homosexuals in their ranks.

The AMA now has decided to jump into the fray and pressure the Boy Scouts to reconsider their decision. One can only wonder what interest the AMA would have in Boy Scouts internal affairs, but the Rhode Island delegation entered a resolution on this matter under the guise that homosexual youth have a higher incidence of suicide.

I have yet to find one physician who believes there is a relationship between the Boy Scouts' decision to ban homosexuality and increased suicide risk in adolescent homosexuals. Nevertheless, this resolution passed after being amended. The amended resolution states: "Our AMA asked youth oriented organizations to reconsider exclusionary policies that are based on sexual orientation." The resolution as passed is actually far worse than the one introduced, since the exclusion can now apply to Boy Scouts as well as their leaders!

One wonders what the AMA will come up with next? Will they promote sexual promiscuity in the name of tolerance? What about any other kind of illicit activity? Do we have to support every type of aberrant behavior in the name of non-discrimination?

The resolution of the AMA calls into question freedom of association and the ability of private organizations to determine, rightly or wrongly, the nature of their activities. Should not any organization be free to be inclusive or exclusive? What if the Boy Scouts stand firm on their decision to limit their associations to young boys? Can a young girl come along and claim unlawful exclusion? Where will the AMA stand on such an issue?

Sadly however, if a resolution like this can get past the AMA House of Delegates with minimal discussion, I certainly don't want to see my dues money in that sort of organization.

Kenneth D. Christman, MD
Dayton, OH

Even some gay/lesbian groups stand by the Boy Scouts because they believe in their own freedom of association! -Ed.

"Point-Counterpoint": Should Physicians Routinely Inquire About Guns?

Dear Dr. Faria,

I read with great interest, excerpts from your article (appearing today on the Medscape web page) about physicians asking patients about ownership of firearms. I could not agree more with your position. Far too often, members of our profession step beyond the bounds of medicine and wellness to promulgate their own social and/or political agendas, eroding our credibility when addressing legitimate medical issues. As you know, more children lose their lives in backyard pools than from firearm accidents, yet no cries are heard to ban wading pools. The demagoguery with which some of our colleagues cite tragically flawed "studies" that include "children" up to twenty years of age is infuriating.

I applaud you for having the courage to take a stand on an issue that often draws hateful criticism from within our profession.

Timothy R. Bonine, MD
Major, Medical Corps, USAF
341st Medical Group

Correspondence originally published in the Medical Sentinel 2001;6(4);109-110 Copyright©2001 Association of American Physicians and Surgeons (AAPS).