However, what is the reality of today’s patient-physician relationship? The picture is the opposite of what was just described as high quality medical practice. Recently, there was a published study (Ann Intern Med 2016; 165: 753-760) following physician time spent on direct clinical face time with patients versus time with the electronic health record (EHR) and administrative tasks.
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According to the findings, for every hour physicians provide direct clinical face time to patients, nearly two additional hours are spent on EHR and desk work within the clinic day. Outside office hours, physicians spend another one to two hours of personal time each night doing computer and other clerical work.
These expanded clerical requirements have had a serious negative impact on the actual time physicians have with patients, thereby compromising care.
In essence, instead of being able to focus their energies on their patients, physicians have been converted into data entry clerks because of ill-advised Congressional actions, primarily the HITECH Act and the Medicare Access and Chip Reauthorization (MACRA) Act.
Making matters worse, the information demanded by these laws is neither rigorous nor based on the scientific method, making the usefulness of this robust data accumulation grossly exaggerated. Thus, the process of skillful medicine as described does not take place, the patient-physician therapeutic relationship is being destroyed, medical errors are bound to increase, patients suffer and physician malcontent is increasing.
It is inescapable that our Congress, by enacting HITECH and MACRA, demonstrated that they have no understanding of the complexities involved in caring for patients. Their misguided obsession of collecting relatively useless data at the expense of patient care makes our Congress the major source of medical errors in the United States.