In the late spring of 2009, I got this crazy idea of opening up my own practice as a solo practitioner. I was sitting in my Friday morning clinic block at Hopkins, seeing somewhere between 8-10 patients a week, when I came into a room to see an interesting young woman with slightly buggy eyes. Turns out, she was a specialty physician working in private practice for her thirteenth year in a row and she later in the visit would tell me private practice was the best thing she ever did. I, on the other hand was in my first year of junior facultyship at an academic pressure cooker and still trying to come to a conclusion about being overworked and underpaid compared with my private practice colleagues. But I will save the rest of that conversation for another day. My doctor-patient turned out to be a pivotal figure in my life and soon I was carefully planning to open my very own practice in downtown Washington.
One of the things my practice manager and I wanted to do from the very beginning was to get away from paper charts and all the pitfalls I had previously experienced. From lost charts, to missing test results, to needing to constantly refile charts after visits, our motivation was pretty clear. In August of 2009, we started combing through blog after blog and website after website trying to find that perfect combination of price, form and function. We finally settled on a moderately-priced, middle of the road model and signed the contract on the dotted line. A server was bought. Thin-client dummy terminals were installed. And life was going to be organized and GOOD without paper charts!But the best laid plans of mice and men are, of course, not always so easily pulled off. For three months from November 2009 until the beginning of February 2010, we struggled with unfinished training sessions, broken software links, and a multitude of things just plain not working. These issues were followed by an outsourced team in India telling us that all problems would be solved to our complete satisfaction. We tried to be patient, listening to the software vendor’s excuses and promises. Day after day of frustration went by, and soon it was up to month after month. At the beginning of February 2010, we decided to fire the company and go with a different one. We initially demanded all of our money back for product misrepresentation. Fortunately, depending on how you look at it, we had only paid half of the complete bill earlier on, citing that payment would only be completed when we had a completely functioning product. This never happened. And so we finally settled for a partial refund minus $2000. Talk about insult to injury! But we needed to move on as quickly as possible, and we had patients to see and take care of, after all. Could we have won in court? In a nanosecond.
As far the company we fired, we agreed to sign a gag order in order to get any money back, and so they remain carefully hidden in the shadows. But if you can read the details above, it probably won’t be difficult to stay away from this one. In retrospect, nevertheless, we should not have let our EHR disaster get so far. As soon as promises were made and not kept more than once, we should have read the writing on the wall and gotten out. Lesson learned!
Dr. West is an endocrinologist in private practice in Washington, DC. He completed fellowship training in Endocrinology and Metabolism at the Johns Hopkins University School of Medicine. Dr. West opened The Washington Endocrine Clinic, PLLC, as a solo practice in 2009.