driving away 40 years of irreplaceable clinical experience ?

Move to Electronic Records Has Pushed Doctors Out

About a decade ago, a doctor friend was lamenting the increasingly frustrating conditions of clinical practice. “How did you know to get out of medicine in 1978?” he asked with a smile.

“I didn’t,” I replied. “I had no idea what was coming. I just felt I’d chosen the wrong vocation.”

I was reminded of this exchange upon receiving my med-school class’s 40th-reunion report and reading some of the entries. In general, my classmates felt fulfilled by family, friends and the considerable achievements of their professional lives. But there was an undercurrent of deep disappointment, almost demoralization, with what medical practice had become.

The complaint was not financial but vocational — an incessant interference with their work, a deep erosion of their autonomy and authority, a transformation from physician to “provider.”
As one of them wrote, “My colleagues who have already left practice all say they still love patient care, being a doctor. They just couldn’t stand everything else.” By which he meant “a never-ending attack on the profession from government, insurance companies, and lawyers . . . progressively intrusive and usually unproductive rules and regulations,” topped by an electronic health records (EHR) mandate that produces nothing more than “billing and legal documents” — and degraded medicine.

I hear this everywhere. Virtually every doctor and doctors’ group I speak to cites the same litany, with particular bitterness about the EHR mandate. As another classmate wrote, “The introduction of the electronic medical record into our office has created so much more need for documentation that I can only see about three-quarters of the patients I could before, and has prompted me to seriously consider leaving for the first time.”

You may have zero sympathy for doctors, but think about the extraordinary loss to society — and maybe to you, one day — of driving away 40 years of irreplaceable clinical experience.

And for what? The newly elected Barack Obama told the nation in 2009 that “it just won’t save billions of dollars” — $77 billion a year, promised the administration — “and thousands of jobs, it will save lives.” He then threw a cool $27 billion at going paperless by 2015.

It’s 2015 and what have we achieved? The $27 billion is gone, of course. The $77 billion in savings became a joke. Indeed, reported the Health and Human Services inspector general in 2014, “EHR technology can make it easier to commit fraud,” as in Medicare fraud, the copy-and-paste function allowing the instant filling of vast data fields, facilitating billing inflation.

That’s just the beginning of the losses. Consider the myriad small practices that, facing ruinous transition costs in equipment, software, training and time, have closed shop, gone bankrupt or been swallowed by some larger entity.

This hardly stays the long arm of the healthcare police, however. As of Jan. 1, 2015, if you haven’t gone electronic, your Medicare payments will be cut, by 1 percent this year, rising to 3 percent (potentially 5 percent) in subsequent years.

Then there is the toll on doctors’ time and patient care. One study in the American Journal of Emergency Medicine found that emergency-room doctors spend 43 percent of their time entering electronic records information, 28 percent with patients. Another study found that family-practice physicians spend on average 48 minutes a day just entering clinical data.

Forget the numbers. Think just of your own doctor’s visits, of how much less listening, examining, even eye contact goes on, given the need for scrolling, clicking and box checking.

The geniuses who rammed this through undoubtedly thought they were rationalizing healthcare. After all, banking went electronic. Why not medicine?

Because banks deal with nothing but data. They don’t listen to your heart or examine your groin. Clicking boxes on an endless electronic form turns the patient into a data machine and cancels out the subtlety of a doctor’s unique feel and judgment.

Why did all this happen? Because liberals in a hurry refuse to trust the self-interested wisdom of individual practictioners, who were already adopting EHR on their own, but gradually, organically, as the technology became ripe and the costs tolerable. Instead, Washington picked a date out of a hat and decreed: Digital by 20Move to Electronic Records Has Pushed Doctors Out15.

The results are not pretty. EHR is healthcare’s Solyndra. Many, no doubt, feasted nicely on the $27 billion, but the rest is waste: money squandered, patient care degraded, good physicians demoralized.

Like my old classmates who signed up for patient care — which they still love — and now do data entry.

Charles Krauthammer is a Pulitzer Prize-winning syndicated columnist, published weekly in more than 400 newspapers worldwide. From 2001 to 2006, he served on the president’s Council on Bioethics. He is author of the New York Times best-seller “Things That Matter: Three Decades of Passions, Pastimes and Politics.” For more of Charles Krauthammer’s reports, Go Here Now.

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3 Responses

  1. I don’t blame Obama much, other than just hating how easily things can be mandated yet not trained for. There are idiots in our doctors’ offices, most of whom have no real idea how to run EMR. Limitations on the escript format create the dual mismatched sig phenomenon. Doctors are resending already sent orders over and over, or sending corrections with no notes to cancel previous rx.

    It’s a mess and it’s placing patients in danger.

  2. Remember it was also his idea to have the IRS and HHS be linked to your health records as part of his whole national healthcare scheme because the IRS was to be the enforcers of making sure everyone had insurance and collect the FINES (i refuse to call it a tax regardless of what SCOTUS said). So 2 days ago, the IRS was hacked and 100,000 taxpayers had their personal information stolen!! Anthem/Blue Cross was hacked for medical information……Seriously, personal medical information is now MORE valuable than banking info….insurance fraud is ripe for the taking, getting your pain meds filled now is difficult, imagine being told you had a pain med script filled in another state you’ve never been to 3 days prior because someone stole your medical info unbeknownst to you and got a fake drivers license (not hard to get these days with the technology) in your name with their picture on it and insurance card with your info and now you cannot get any of your legitimate scripts filled, pain meds or otherwise. It’s slowly becoming the new identity theft. Why I’m not a fan of EHR….they don’t have the medical records locked down tight enough for me…..way too much electronic sharing……I don’t care for E scripts either…sure convenient..but seeing too many errors…more than what was on paper scripts

  3. Too bad the author ruined this article with the political blame game, using words like “liberals” and the mention of Solyndra. Bias like this makes the rest of his words have a lot less impact.

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