I read with interest your comments on EHRs (Last Word, October 25, 2017). I thought I would share with you a few of mine as a family physician since 1980.
I have worked with computers since starting college at Caltech in 1966 when we used IBM punch cards for our programs. However, when the HITECH Act was passed, I realized right away that it was a huge mistake. Though there are multiple applications for which computers are a boon, the practice of medicine isn’t one of them.
As you mention, “data entry is … a distraction from patients.” I saw that coming back in 2009, as I envisioned doctors staring at computer screens instead of looking at their patients, thus missing the all-important non-verbal cues so critical in communication. Also, after many years’ experience with several different software billing programs, I knew how costly EHR systems would prove to be over their usable lifetime. I tried to warn my colleagues not to buy into HHS’ siren song and accept their utterly inadequate incentives. Few would listen.
Even now, those who advocated such systems still try to convince us that their promised interoperability is just around the corner. EHRs “just need some tweaking” to deliver on this, we are told. It’s another false promise. If your firewalls are sufficient to keep your records from being hacked, that same security system will keep other doctors out, especially at night when doing ED shifts. Of course, during the day, you can always call the patient’s doctor’s office and get the information you need faxed to you or even speak directly with that doctor over the phone-if he or she isn’t tied up with an EHR.
Let’s all be fully honest with one another. The EHR is an application which harms healthcare delivery more than enhancing it, and it always will be. Computer software is great for billing and similar number-crunching, but not for direct patient care.
Gary Yarbrough, MD
Elizabeth Rosenthal, MD, author of “An American Sickness” mentioned physicians’ frustrations with the bureaucracy of medicine and no control over prices as a major concern. (Medical Economics, August 10, 2017).
But my experience is that physicians’ frustrations over lawsuit abuse and frivolous malpractice suits are an even greater concern.
The threat of frivolous suits forces doctors to order unneeded tests and consultations. This “defensive medicine” raises costs. It’s one reason why doctors are powerless to control prices.
If lawmakers understood how frivolous suits raise the cost of healthcare, they would eliminate the ambiguities in the law that permit frivolous suits.
Penalizing attorneys who bring frivolous suits would be even better.
Edward Volpintesta, MD