Thursday, March 22, 2012

WHEN A ROSE IS NOT A ROSE

(With apologies to Gertrude Stein)

Every occupation has its own lexicon; phrases and jargon that convey a particular meaning (often with subtle differences) within the profession. Certainly no area has more of these than health care. Unfortunately, in 2012 and beyond, our words are no longer limited to our own profession and we need to understand how they are interpreted by others when they leave our hands.

Last week, I was faced with two instances that highlight this. In the first, I was representing a client in a trial in which the meaning of the phrase, “compatible with” was a determining factor in the outcome. As a physician, how many imaging reports have I seen in which that phrase was used instead of making an actual “diagnosis.” Now, I know why we do this, and certainly understand the lack of precision within Medicine and the use of a differential diagnosis, but it was being used in a legal setting, and the “case law” held that “compatible with” did not equal “diagnosis.”

The second instance in which this was encountered was a hearing in which the use of that phrase was pivotal in whether the health care provider was paid. In that case, its use was held to be “constructively equal” (legal jargon meaning “effectively the same thing”) to making a diagnosis. How can the same phrase be interpreted two different ways in our legal system and both be correct? For that answer I would need much more time and room. Using the correct phrasing, however, is becoming increasingly important for physicians and others in health care to learn, if only to be paid for what you do. It’s time to prepare yourself and your practice for the coming changes in health care.

Speak to a knowledgeable health care attorney about a legal check-up for your practice or facility. Just as it is better and less expensive to prevent disease than to cure it, so it is easier and less expensive to prevent these, and other (more serious) legal problems rather than “cure” them later.