Note from the CCDS Coordinator: Networking support: Dancing with the blinds closed

by Penny Richards

During CDI Week (September 17-21) one of our CDI Talk members wrote in to vent some frustration. She’d spent 50 minutes being berated by a physician. He told her that CDI specialists do not represent the government and that her questions were keeping him from caring for his patients, among other things.

If he’d simply answered her questions, he would have been done in two minutes instead of the 50 he’d spent berating her.

After taking herself to the stairwell for a good cry, she took her concerns to the chief medical officer (CMO) and the vice president (VP) of quality who both supported her efforts, treated her professionally, and eased her frustration. She took to the CDI Talk message board for further support from her fellow CDI professionals.

Here are some examples of the advice and support they provided, further proving that the ACDIS networking community is a valuable resource:

• I [try] not to let physicians get me riled up (though many certainly get under my skin particularly if they insult me or the reason I am here). When a confrontational situation arises, I tell them that I have an appointment to make, and will get back to them.  I then usually go see their chair and get a meeting set up or get my physician advisor to intervene. I try to remind myself and others that physicians are like everybody else; they eat, sleep, die, cry, love, blink, grow hair, and have failings like the rest of us.

• I have a motto that gets me through those moments: ‘It’s nice to be important, but more important to be nice.’ It evens the playing field for me.

• Hang in there… it happens to all of us at one time or another.  If your facility has a code of values which includes mutual respect, you can issue a complaint about the providers conduct. I’ve done that in the past and it worked wonders. We actually got the surgeon to apologize.

• I have had to go into the stairwell to cry as well, don’t worry. In some ways, CDI does represent the government.  We are the buffer for physicians so that the government does not come down on their incomplete documentation with payment denials and low quality scores. We have all been there, haven’t we?

• After those types of interactions, I try to remember why our profession is important. I know that he will change his tune once he receives a Recovery Auditor denial.  If his services are an outlier, he will be touched by the Medicare Angels.  Then, all of a sudden, he will want you on his team. I’ve had that experience—been there, done that—and then danced in my office when the blinds were closed.

There’s a lot of great advice here: reminders to reach out to appropriate staff for assistance when dealing with a colleague who is, for whatever reason, being uncooperative; and that words of encouragement for the individual as well words of support for all CDI specialists’ professional skills and abilities go a long way toward improving confidence and make for a more productive and cooperative work environment.

The physician, while arguably the most important member of the healthcare team, also relies on the skills of the CDI professional. Each brings a different set of skills to the table and it’s only when working together that the patients’ needs will be best served and the reimbursement for services appropriately paid.

Perhaps the best advice she received is that, while it’s okay to find a quiet place and cry out your frustration, there’s a lot more joy in dancing with the blinds drawn.

Editor's note: Richards is the CCDS Coordinator for ACDIS. Contact her at prichards@acdis.org.