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This Thanksgiving I had the pleasure of staying with a top Ophthalmologist in Louisiana and his family. Dr. Vision, we’ll call him, is a premiere eye surgeon in Louisiana and his son is one of my closest friends. He is one of three partners in an influential vision care practice which treat about 80% Medicare patients, and his practice continues to make huge strides in cataract and glaucoma care in the south. So when I asked him over Thanksgiving dinner, “Dr. Vision, what EMR system are you using? Have you got your meaningful use checks yet?” And he responded with an “[Expletive] no.” I was actually more surprised by what he said next…
I have gotten used to hearing the standard excuses doctors have given over the last 20 years why they weren’t implementing electronic charting systems in their offices, and though those were also concerns Dr. Vision briefly mentioned, they weren’t the biggest reason he didn’t want to change. The standards: “EHR will slow me down – I’ll be less productive.” “Paper never crashes.” “I don’t want to change how I’ve been practicing.” “I’m going to retire soon anyway.” Those excuses were all really side-notes in this Thanksgiving conversation. What did come up was one statement, followed by a lengthy discussion:
“I didn’t get into private practice to let the US Government micro-manage how I treat my patients.” I’ve heard some physicians mention this reason before, but generally I just discounted this excuse as government conspiracy-type wild speculation held by a minority of physicians out there. But as Dr. Vision spoke, I began to realize that there were likely a large number of independent U.S. physicians who also felt this way. “I would rather just pay the fines associated with not implementing an EMR rather than give the government any more control over my medical practice. The government wants cookie-cutter medicine and I refuse to give that to my patients.”
Dr. Vision’s perception lies in the reality that over years the government has been slowly taking more control over physician care in this country via Medicare reimbursement incentives. In the 1990’s, it was the guidelines for Evaluation and Management coding. To Dr. Vision that is one of the many ways the US government has said, “Hey, if you don’t follow these steps with your patient care, we’re not going to pay you very much to treat them.” This ‘Cookie Cutter Medicine,’ as he called it, is a huge concern many specialists share, especially since many of these ‘strong-armed’ requirements seem to be aimed more at general or family practice physicians and not specialists. Meaningful Use is just a perceived next step in what feels to some independent physicians as an overactive government trampling on their ability to treat their patients in a personalized and customized way.
Now, if we can only get independent physicians who share this point of view to see and understand the truth about EMR systems. If government interference is their enemy, then a well-designed electronic medical records system is actually their best friend. The truth is, though there will likely always be some level of government interference for both good and bad within medicine, a well-designed EHR system can actually set a physician free from much of the minutia associated with government requirements. For most systems, E & M coding can be virtually automated and electronic charting can be customized to meet the demands of both the government requirements and the unique expectations of the physician using it, but most importantly, an EHR allows the physician to treat the patient as a unique individual with distinctive problems.
Kevin Burdick
Healthcare IT Consultant and Medical Software Reseller Advocate
EMRAnswers.com
NOTE: Dr. Vision has agreed, kicking and screaming, to see several EHR systems including OmniMD. I’ll keep you updated on his progress.
