In our society, someone is held responsible and in fact, must be held responsible. Especially when things aren't going as expected or heaven forbid a disaster occurs....."Who's responsible for this?" Find the scapegoat, quickly!

Should a doctor be held responsible for non-compliant patient's lab results? Let me explain this further. Insurance companies are preparing physicians for financial penalties if a patients chronic illnesses are not 'under control'. With diabetes for example, there are several quality indicators of a diabetic patients care. Is the physician monitoring their kidney function twice a year? Is the physician monitoring their lipid panels twice a year? Is the physician monitoring their HgbA1c twice a year? These are some of the quality indicators and they are all good medicine. Physicians should be monitoring and treating diabetic patients according to laid out quality indicators.

But here's the rub for me. I'm quite diligent about closely monitoring my diabetic patients, making referrals for diabetes education, adjusting medications to better control their blood sugars, etc. I'm also quite diligent about counseling my diabetic patients about changes in lifestyle that will help to control their diabetes and hopefully fore-go any 'down the road' complications from uncontrolled diabetes.

However, humans are humans and many patients just simply refuse to manage their diabetes by altering their lifestyles. They eat whatever they want, they don't exercise, and quite honestly, they aren't taking responsibility for THEIR disease. I tell them...I'm here to guide, advise, educate, and encourage you to live healthy with your disease and possibly show you ways that you can put your disease into remission....but ultimately, it's YOUR disease, not mine.

Ok, that's the scenario. Now I ask you this. Should a physician be financially penalized if a patients cholesterol or HgbA1c is not under control? I think not! I can prescribe medications all day long to control these things, but it's ultimately up to the patient to take the medications and alter their lifestyle. Why should the doctor be financially penalized for a patients non-compliance? It doesn't make sense to me. As if I can control every aspect of this patients life....please, I ain't God! (on most days)

Dammit Jim, I'm just a doctor! (borrowed from Star Trek Original series)