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PATH Audit Effects on Medical Education
Robert Phillips, MD
JAMA. 1998;280:766.
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The words PATH audit can strike terror in the hearts of hospital and clinic administrators, a reaction that I shared during my family practice internship in 1995. Although Medicare patients constituted only 17% of the clinic's billings, the institution chose to apply a stringent interpretation of the Health Care Financing Administration's (HCFA) requirements to all patients out of fear of a PATH (Payment for Academic Teaching Hospitals) audit. Because HCFA's contracted carriers interpreted HCFA's physician supervision rules differently than HCFA itself, academic medical centers have been investigated and, in some cases, fined for not complying with HCFA's interpretation. The broad application of these rules has had both positive and negative effects on residents' clinical training, without either quality of training or patient care being the focus of this change.
On the positive side, during the first 6 months of my internship and before the new rules were . . . [Full Text of this Article]
Academic Fellow and Clinical Instructor
University of Missouri College of Medicine
Columbia
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