UM Regents’ Public Comments

On Thursday, June 20th, Lorrie Carbone, a Clinical Social Worker, shared her deep concerns over the punitive productivity measures attached to billing insurance codes.  

Lorrie’s Statement

“My name is Lorrie Carbone, and I have been a social worker at Michigan Medicine for 23 years. Stress – due the focus on social work outcomes – became so great that I left my position and moved to research. 

Social work outcomes are measured by the number of patients seen and billing data. Social workers are increasingly pressured to see as many patients as possible, focusing on providing resources for one identified problem, with no time to assess for other issues. Social workers are in an untenable position of working mainly to meet the institution’s financial goals. This needs to change.

Think about the range of reasons that people come to us for care. From annual check-ups to chronic illness like diabetes, to cancer, to end-of-life care. Each person has their own story. 

The unique role of medical social workers is they enhance well-being by helping patients cope emotionally with changes in health and functioning, provide health education and connect them to helpful resources. 

Unfortunately, health care billing prioritizes medical services and the number of services provided over effective patient care. I’ll give an example:

In Family Medicine, a male patient with diabetes, had both legs amputated below the knees and was homeless. He had been on the waitlist for subsidized housing for two years and had just received a call about an apartment being available, but he needed to get there that morning to sign the lease. No family member could take him. 

Think of the loop of poverty, chronic illness and homelessness and their effect on one another. His future health and well-being were at stake. It took over an hour and multiple phone calls to arrange for him to get to the office to sign the lease. 

This lengthy intervention would be frowned upon now. Social workers are covering multiple areas and clinics. They have only enough time with patients to give them resource information. The patient and family need to make the calls. There is no follow-up to make sure their needs were met.

Social workers are not alone, as Michigan Medicine has increased pressure on dietitians, occupational and physical therapists, and other staff to see more patients and increase profits. 

This focus on profits means patients and families are not “first” at all. This has led to dissatisfied patients and unhappy and burned-out staff. 

We as UMMAP members ask that you reach a fair agreement with us that eases these profit-motivated pressures on staff so that we can effectively help patients and families and do the jobs that we love.”

Support Comprehensive Patient Care

UMMG productivity metrics are an increasing problem for many of our members.  The integrated patient care we can provide does not fit neatly into insurance billing codes that drive UMMG’s productivity metrics.  Our patients and work are much more than insurance billing codes.  

Union siblings and community allies, you can stand with us to put pressure on UMMG leadership to do the right thing for comprehensive patient care.   You can add your name to our open letter to management here:  UMMG Pressure Campaign MOU Support.

In Solidarity,

UMMAP UMMG Pressure Campaign Committee