The truth behind medical paperwork

Someone I know asked me to join her at her therapy session today, primarily to discuss communication styles. I agreed. The councilor greeted me kindly, said how much good stuff she had heard, and then handed me a (rather thick) sheaf of papers to fill out. Needless to say, I was nonplussed. I smiled and asked her why it was necessary for me to fill out this paperwork, explaining that I have an aversion to such things, and after all this was a one time thing. She said it was for her "integrity" because this paperwork is required by her various associations. She also said that her lawyer said she must have it filled out. She questioned me about past experiences with paperwork - playing the 'why' game with me. At one point I asked her what she would do with the paperwork when I filled it out, and she said "Oh, I'll file it away for 8 years and then throw it away."

So she wants me to do work that she'll then throw away. How respectful of my time and efforts!

The truth is that paperwork serves only two purposes: to get the service provider paid, and to limit their liability. And because the payment often comes from a 3rd party (the insurance company), an inordinate amount of paperwork is required. Another, more egregious purpose behind paperwork is to limit the service providers liability. It is more egregious because lawyers have to guess how lawsuites might play out, and because they can go in many different directions, there's a lot of paperwork generated. Actually the more general way to put it is that paperwork should limit the eventual harm suffered by either party (although in some cases it increases harm, such as imposing punitive late fees).

Repetative, unnecessary paperwork one of the worst symptoms of our medical system.

One should justify paperwork, rather than justify not having paperwork. It's not easy to fill out a complicated form, especially if it's packed with technical jargon. The requested information is often not at hand, and even if it is, one has to painstakingly write it neatly in the boxes. Also, the action is asymmetrical, meaning that the service provider doesn't have to fill anything out for you, but you have to fill stuff out for them. It is demeaning because, as in my case, you are asked to do work that will eventually be thrown away. Paperwork is the worst kind of work - it's just rehashing known information into new blocks, and agreements that can't be fully understood.

In this case there are privacy concerns which are substantial - what if I apply for medical insurance and the councelers billing department submitted my "claim" for pscyhological treatement such that my premiums got adjusted?  Or what if the billing department decides to bill me for the visit by accident?

It makes me very sad that otherwise rational people let bearucratic habits trump their common sense. The fact is that I should have been able to sit in with my friend that one time without filling out any paperwork whatsoever, because the only potential harm was to my privacy, and I felt sufficiently covered by confidentiality priviledge.

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