Montana Medical Assn.: We support Dr. Vargo
Regarding your article about Patsy Vargo, MD, "Feds try new tack in charging doctor with upcoding"
(AMNews, Feb. 21 ), the Montana Medical Assn. wishes to provide insight to our physician colleagues across the country so they may better understand and interpret the information that was published by AMNews about this case.
The membership of the Montana Medical Assn. strongly supports Dr. Vargo and strongly believes she will be exonerated. The association membership also believes this action is an example of the criminalization of the practice of medicine and the denial of due process rights, to which all people are entitled, under the guise of "fraud and abuse."
In Dr. Vargo's case, justification for her coding was reviewed by a peer physician selected by the government and her coding was found to be in line with the services she provided, and therefore, the initial criminal action was dropped. Graphs and charts such as those used in your article to compare one physician with another are not as germane as studying the services actually provided and the coding entered for those particular services.
On examination, Dr. Vargo's coding was found to be in line with the actual services needed and provided to patients. The care that she made available was highly sought by the patients in her community. Her ob-gyn skills resulted in her clinics being extremely full, with a waiting list because of patient demand for these services. Unfortunately, full information about Dr. Vargo's case cannot be presented at this time because the civil aspect of the case has not been completed, and information is restricted by her defense counsel.
Hopefully, physicians across the country will recognize the threat of this type of activity. It clearly exemplifies abuse of power by the government. It is to be hoped that when this case is resolved in Dr. Vargo's favor, it will serve as an example that will lead to correction of these criminalizing processes to the benefit of physicians and all persons subject to government regulation.
--James E. Jarrett, MD
President
Montana Medical Assn.
Helena, Mont.
Editor's note: Also signing the letter were all the members of the Montana Medical Assn. Executive Committee, including Dr. Vargo.
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Reject masochistic role in health care
Many physicians have experienced, at all levels of training, physicians and other health professionals being verbally and emotionally abusive. All senior physicians need to correct trainees, but if they cannot do that without losing emotional control -- get treatment and be humble. It may prevent an addiction or a divorce.
The larger issue for all physicians is accepting a masochistic role and allowing themselves to be mere objects -- a process that starts early. The same beaten-down doctors-in-training will be more accepting of absurd payments, lawsuit abuse, ignorant and useless utilization review and paying massive overhead for coding to fit insurance submission standards.
Having personally experienced highly unsettling and unreasonable emotional and verbal abuse, not merely at the hands of "model" physicians but also from nurses, residents and social workers, I have nevertheless decided to try to let such a cascade of aggression stop with me, and focus on the present for a different personal future. My goal is sometimes a challenge during stressful times when staff in "training" let me down.
Practically, that has meant developing, over five years, a practice that has no association with insurance supervision, no staff for office insurance form processing, no Medicare problems and no lawsuit-oriented patients. My model is not for those who require millions in equipment, but only one example of a satisfying medical practice in which I am not a masochistic object, but the leader of the care.
--James Schaller, MD
Chester Springs, PA.
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Little to learn from humiliation
Regarding "It's a rough world in medicine; get used to possibility of bruised ego"
(Letters, March 27): I read with dismay this letter to the editor by Thomas J. O'Dowd, MD, of Voorhees, N.J. It is my opinion that Dr. O'Dowd's letter is an example of much of what is wrong with our profession. With gross generalization and lack of empathy, Dr. O'Dowd maintains that the times he was belittled and humiliated made him a "better physician." The only impression I received from the content and tone of his letter was that he has unconsciously or consciously chosen to continue in the destructive but time-honored good ol' boy tradition of: I got it when I was a student and now they can, too.
I have found that in medicine, whether it is with our patients or our colleagues, kindness and a modicum of dignity make difficult work easier and even enjoyable, and in the end, it is such qualities in the relationships we have with those individuals that matter most. It saddens me to read of the abuse of a population that is not in an equal position to fight back. It's not instructional; it's just plain mean.
--Gregory J. Davis, MD
Frankfort, Ky.
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