Thursday, October 09, 2014
Doctor's Perspective
Finding waste in our medical care system

By Dr. Anthony Policastro
The Centers for Medicare and Medicaid Services (CMS) spends a lot of time talking about waste in our medical care system. They talk about excess charges by hospitals and physicians filing fraudulent claims. What they do not talk about is the money that they waste within their own bureaucracy. For example, I just received my 2015 Medicare booklet from the CMS. The front cover features highlights of the booklet. The cover indicates that the section on What's important in 2014" is on page four. Actually, it is What's important in 2015" not 2014. And it is on page 12, not page four. The cover also indicates that the section on What Medicare covers" is on page 29. It is actually on page 35. The first question that comes to my mind is how much did it cost to create the book? The second question is how much did it cost to mail these to every Medicare beneficiary? I suspect that these costs are not insignificant. I also wonder who was responsible for proofreading the final version. Of greater significance is that it also makes me wonder if the cover has errors is any of the information in the book accurate? Clearly some information in the booklet cannot be checked for accuracy which suggests that they may have other inaccuracies that have gone unnoticed. The headlines are aimed at errors in our medical care system. That is easy to do because everyone makes errors. For example, I may have a patient come in who is very complicated. At the end of the visit, I need to decide how to bill the visit. There are levels for me to select. I may select a low level. However, after a review, it may actually be that I could have billed at a higher level. I could have obtained a higher reimbursement from the insurance company. I will be the one that loses money. However, strictly speaking, the bill was fraudulent." It was not as high as it should have been. If I do that one time out of 10, you could report me for fraudulent" billing 10% of the time. However, the loss would be mine not the insurance company's. That might not be made clear with this headline: Dr. Policastro bills fraudulently 10% of the time." In the meantime, the headlines ignore the expense and inaccuracy of CMS. They got one out of three things correct on their cover. Therefore, we could say that CMS provided wrong information 1/3 of the time." Now that would make for an interesting headline. If you have comments about this column or suggestions for other topics, send an email to Dr. Anthony Policastro at

Book Sale at Look-In Glass Shoppe The Look-In Glass Shoppe at Nanticoke Memorial Hospital is hosting a Books Are Fun" fair featuring quality books and unique gifts at great savings from 7 a.m. to 4 p.m. on Thursday, Oct. 9 and 7 a.m. to 3 p.m. on Friday, Oct. 10. The event will be held in the medical staff conference room. For more information, call 629-6611, ext. 2475.

Sweet Serenity fundraiser In honor of Breast Cancer Awareness Month and to help the local community, Sweet Serenity Chocolates in Seaford has pledged to donate 10% of the store's proceeds for the month of October to Nanticoke Cancer Care Services. Money raised will be used to support Nanticoke Cancer Care Services patients undergoing radiation or medical oncology services. The cancer program at Nanticoke also helps patients through support groups, providing assistance with transportation when needed and helping patients navigate the health care system through its care coordinator. Sweet Serenity Chocolates is located at 1001 Norman Eskridge Highway, Seaford and can be reached by calling 628-8883 or visiting

Drive-thru flu clinic Peninsula Regional Medical Center's Drive-Thru" Flu Clinic returns on Thursday, Oct. 16 and Friday, Oct. 17 from 10 a.m. to 6 p.m., at Arthur W. Perdue (Shorebirds) Stadium in Salisbury, Md. Vaccinations will be administered to individuals 13 or older. A donation of $10 per vaccination is requested.

Dean joins Aquacare Aquacare Physical Therapy announces the addition of Erin Dean, DPT as staff physical therapist and incontinence/pelvic floor specialist at Aquacare's Seaford and Salisbury, Md. offices. Dean, a Salisbury native, earned an undergraduate degree in history and gender studies in 2005 from Salisbury University. She earned her doctorate in physical therapy from the University of Maryland Eastern Shore. Dean then received specialized training with the Herman & Wallace Pelvic Rehabilitation Institute, receiving certification in pelvic floor evaluation and treatment interventions. Dean worked as an exercise specialist and performed her final clinical internship at Aquacare.

Sleep apnea support group Nanticoke Memorial Hospital in Seaford is hosting the A.W.A.K.E. - Alert, Well, and Keeping Energetic, sleep apnea support group. A.W.A.K.E. is a free support group for people with sleep problems including sleep apnea, insomnia, excessive daytime sleepiness, restless legs and narcolepsy. The support group also focuses on the impact medications may be having on your sleep. Family and friends are welcome to attend. Meetings will be held from 2:30 to 4 p.m. on Wednesday, Oct. 22 and Wednesday, Nov. 19, at the ground floor Nurse's Conference Room. There is no meeting in December. For more information, call the Sleep Disorders Center at 629-6611, ext. 3815.

Stroke support group Nanticoke Memorial Hospital's next Stroke Support Group meeting is at 1:30 p.m. on Tuesday, Oct. 21, at the Seaford Library. The two-hour meetings consist of guest speakers and breakaway sessions, in which caregivers and stroke survivors meet in two groups to discuss concerns, provide support and allow for networking. Refreshments will be provided. Pre-registration is not required for this free support group. For more information, contact Nanticoke Memorial Hospital at 629-6611, ext. 8626.

Rabid fox is found in Millsboro Delaware's Division of Public Health (DPH) warns residents of the Hub Court Mobile Home Park just off Rt. 113 in Millsboro about a fox that tested positive for rabies at the DPH Lab on Tuesday, Sept. 30. The fox bit an individual from this community before being caught and tested for rabies. DPH is contacting those known to have come in contact with the fox and urging they get post-exposure rabies treatment. Anyone who thinks they may have been bitten, scratched or had saliva contact with any fox in that area should contact their healthcare provider, or call the DPH Office of Infectious Disease Epidemiology at 888-295-5156. Residents should always take precautions against rabies by avoiding wild or unfamiliar animals and ensuring their pets are up-to-date with rabies shots. Since January 2014, DPH has performed rabies tests on 109 animals, seven of which were confirmed to be rabid. For more information, contact the Office of Infectious Disease Epidemiology at 888-295-5156.