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Letters to the Editors
EHRs: How can we afford them? While I fully agree with the idea of an electronic health record system as discussed in "EHRs: the Feds' big push" [Aug. 20 http://www.memag.com/memag/article/articleDetail.jsp?id=114224], I feel the government's panel of experts missed the real point. Folks, the money simply isn't there! I was told that a certain fully integrated front-office and clinical EHR system for a two-doctor practice would cost in excess of $150,000. (I haven't seen another system that's as complete.)
I don't see the likelihood of EHRs gaining universal acceptance until physicians are free to do what every other businessperson does: pass on the cost to the customer. The EHR will remain an unattainable dream as long as the FTC and Congress allow the insurance industry to rob this country of the best healthcare delivery system the world has ever known!
William A. Delp, DO Loganville, GA
I actually find it useful to tell new patients that my number is in the book. For example, when a nervous, first-time mother calls about her sick kid, I can calm her and avoid an expensive emergency room visit.
For me, having a published number is not a problem. Maybe it's different in big cities.
Mike Cochran, MDCrockett, TX
Please simplify he codes There's something wrong when documenting a patient visit in the chart using the precisely correct diagnosis codes takes three times as long as seeing the patient ["Coding Consult: Diabetes care," Sept. 3 http://www.memag.com/memag/article/articleDetail.jsp?id=120972].
As a busy internist who sees patients with many different types of problems, I can't begin to memorize all the codes I use, and to code with the precision your consultant recommends would take an inordinate amount of time.
We need to streamline the coding process. Doctors should have to provide only enough information to justify the visit or any tests. Those who need more-detailed information (for the statistical analysis of the health of a given population, for instance) must realize that our coding system cannot be expected to provide such data.
Cynthia Point, MDSan Francisco
When high expectations lead to lawsuitsWhy are there so many frivolous malpractice lawsuits? That's the real question behind articles like your interview with Dr. Fagel, "How I pick the doctors I'll sue" [Aug. 20 http://www.memag.com/memag/article/articleDetail.jsp?id=114229].
The answer lies in the public relations buildup of modern medicine that gives patients the impression that, nowadays, doctors can do just about anything. Most patients are not educated enough to realize that, in spite of technical advances and conscientious care, there are still loads of things medicine can do nothing about. So to them, every bad result is actionable.
Until the medical profession stops blowing its horn and makes sure the media gives equal attention to the unknowns and drawbacks of treatments, people will expect perfect outcomes no matter what. And when they don't get them, they'll run to the lawyer.
Evelyn W. Bradford, JD Waynesboro, PA
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