This article was originally published on 1/24/2012

I was recently reminded of the fable of the straw that broke the camel’s back.

The Pennsylvania Medical Society website received a flurry of comments – more than 50 in about a week – on (what we thought) was a rather innocuous article outlining new interim regulations for health care worker ID badges. But it wasn’t so much the number of comments that took me aback; it was their tone. Some physicians were really ticked off. Many took the time to write long complaints.

One anonymous writer posted, “Badges, we don’t need no stinking badges.” (Incidentally, if you want to see two very short videos check these two out: From Treasure of the Sierra Madre. From “Blazing Saddles.”)

Others said: “Physicians in this country are turning to be government’s puppets.”

“This is ludicrous, not adding to patient care, which should be the number one goal of medicine, but only adding to further legal hurdles and financial burdens.”

“Typical example of excessive regulation. What happened to common sense? And using one’s brain a little???”

The law aims to minimize patient confusion. Physicians and their staff in private medical practices are now required to wear photo ID badges, and there will be specific rules about badge size, wording, etc. Last year, the Pennsylvania Medical Society lobbied to support the concept, but we agree with many of your comments and aren’t happy with the way the regulations have been implemented so far. We’re working to help physicians understand the regs and solve some problems with implementation.

To those who said, “My patients already know who I am,” I applaud you. Certainly, when I was solo that was true! But to those of you in larger groups who said “We don’t need this,” I’d remind you that you have an ever-changing staff and your patients don’t always know who is talking to them. And to those who work in hospitals and took the time to complain, I would remind you that a clear ID badge on a white coat could be a lifesaver. Don’t your patients need to know who’s asking when some unknown person enters their room and says, “I need to do this….”?

But the regs aside, I’m more interested in why they sparked so many comments. Why haven’t we seen this many comments to other stories – on things like physician leadership? Community health?

My theory is that the ID badge problem simply brought it all home – it was the straw. It brought into focus the daily burdens of patient care vs. myriad rules and regulations – meaningful use, insurer contracting, hospital credentialing, ICD-10 coding, threats to Medicare and Medicaid reimbursement, etc. And it was something that was fairly easy to complain about.

Maybe the real issue – the one that should spark outrage and fist-waving and web commenting — is how we have allowed medical management to be taken away from us. How can we turn physicians’ outrage into action to take on leadership in Quality, Value and Community Health? And what action?

*http://en.wikipedia.org/wiki/Stinking_badges accessed 1/17/12