I realize that that’s a kind of catch all title, but it seems to be the case the more doctors I talk to about healthcare. Don’t get me wrong. I know a bunch of optimistic doctors. They are optimistic about life. They are optimistic about their patients. They are even optimistic about the future of the care that can be provided patients. In fact, it’s hard to be a doctor today and not be a bit of an optimist.
However, amidst all of that optimism I don’t many (possibly any) doctors that are optimistic about where healthcare is headed. We write about technology and EHR most of the time here, but this goes far beyond technology. Sure, EHR is the scapegoat for complaints when many times the real complaint is about the healthcare system in general.
My post about the myth of “Too Many EHR Clicks” has drawn the ire of many doctors. While there are plenty of issues with EHR software (especially some of them), most of the complaints I hear about too many clicks are a reflection of regulation and reimbursement. It still begs the question of whether an EHR can be beautifully built with very few clicks in the current regulation and reimbursement environment.
I get the pain. This tweet is an example of doctors reactions:
Had another physician client walk away from medicine. Reason? Too much time in front of computer and not enough time with patients. #hcldr
— Carolyn McClanahan (@CarolynMcC) October 8, 2015
I could just as easily hear about doctors leaving medicine because they were spending too much time charting and not enough time with patients. Imagine if the meaningful use requirements were around in a paper chart world. We’d have even more complaints about time spent charting than we have today with EHR.
All of this to say that I don’t see much optimism about the future of healthcare from the doctors I meet. Will we reach the point that doctors kick against all of these pains and something changes? Do you see something on the horizon that will alleviate the pains that doctors now deal with today?
I’m excited by the technologies that will come out and change healthcare. I’m not optimistic that regulations and reimbursement will get any better. In fact, a lot of signs point to it getting much worse.
Simple answer to your question….No…
There is a tremendous imbalance now. Everyone wants data, discreet granular data, then CMS or someone else takes that data and cuts and slices it and does pop health or whatever. All on the backs of physicians and providers that are expected to be data entry personnel, we enter the data, and someone else tries to make money on it. We are the worst possible choice for data entry. We did not choose medicine to sit in front of a computer and peck away at drill down to find ‘displaced transverse fracture of the left lower end of the radius, closed, subsequent encounter with routine healing’. The blowback is coming. I find it funny when we hear that MU or JACHO or someone wants some other data entry workflow requiring more computer time and every department from pharmacy to nursing to lab or whatever all say that they don’t have time to enter info into the computer and they come running back to the physicians and providers and then try to dump it on us. Its totally ridiculous. I really think you want your orthopaedic surgeon to be really good at that, orthopaedic surgery, and not counting numerators and denominators for TOC and SOC documents or tapping away at a computer. We are to synthesize data, not enter it. Its all screwed up now. Not only are we to enter all the data, synthesize it, and then actually practice medicine all within a very small time frame or people get mad that we are behind. It puts a tremendous burden on physicians that remain when physicians leave medicine as they are now. If ONC or CMS wants all this data entry then they need to redo all the payments to include a data entry person to be hired for every physician. That has to be in the payment equation. And the interop has to be MUCH simpler than it is now. It should be google or wikipedia easy, right now its impossible. And no matter how many modifications of MU that seem to come about, we are completely over burdened. Hence only 10% of physicians attesting to MU2. We are giving up. And when we give up, watch out…the blowback will be expensive and terrible to all of healthcare.