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    Physicians leaving profession over EHRs

    Until recently, most doctors created their own workflows and utilized only the technology they were comfortable using. But with the implementation of the Health Information Technology for Economic and Clinical Health Act (HITECH Act) in 2009 to stimulate the adoption of electronic health records (EHR), many physicians are finding things a bit too stressful.

    In fact, a new study in Mayo Clinic Proceedings showed that physicians who are uncomfortable using EHRs are more likely to reduce hours or leave the profession.

     

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    The research showed that while EHRs hold great promise for enhancing coordination of care and improving quality of care, in its current form and implementation, it has created a number of unintended negative consequences including reducing efficiency, increasing clerical burden and increasing the risk of burnout for physicians.

    Tom Davis, MD, FAAFP, who practiced family medicine for almost 25 years in the greater St. Louis area, says the primary reason he walked away from a successful practice was the EHR, citing its use, the ethics and the burden.

    “I had 3,000 patients, many I’ve known for a quarter century, a few hundred of which I delivered, all immensely valuable relationships—and all burned to the ground mostly because of the burdens of the HITECH Act,” he says. “The demands of data entry, the use of that data to direct care and my overall uncertainty about how medical data was used in aggregate all helped poison the well from which my passion for serving my patients was drawn.”

    He believes that the information collected through the EHR is being used (at least in aggregate) for purposes other than the direct benefit of the individual patient so it would be unethical for him to represent otherwise to the patient. As far as the burden, he notes he spent about four minutes of keyboard time for every minute of face-to-face time with a patient.

    Next: Significant decrease in productivity

    Keith Loria
    Keith Loria is a contributing writer to Medical Economics.

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    • [email protected]
      I am an older ( 60 ) FP doc who is comfortable with computers, and I can type fast ( took 2 years of typing class in high school, which has come in quite handy over the years ). I also work ER where we have an EHR, and our office was still paper and dictation/transcription. I can see an acute otitis externa in the office in less than 5 minutes; in the ER I timed it at just under 15 minutes from the time I opened the chart to when I signed off electronically. It only gets worse, from an efficiency standpoint, on more complex patients. I completely agree that the systems were designed by non-clinicians, and optimized for coding and data capture, not patient care. Much of what I do on the EHR could be done by someone with a high school education. Physicians should be taking care of patients, not electronics!
    • [email protected]
      The only way to optimize the EHR is to disintermediate care, especially primary care. All EHRs do today is feed the data beast and maximize profits for hospitals, health systems and PBMs. Algorithms derived from big data are destroying our healthcare system. In fact, we don't have a healthcare system, we have a sickcare system.
    • Anonymous
      EHR optimization phase? Don't make me laugh! I await a single comment from a physician who feels their EHR has been, or is being, optimized, for anything other than population health and/or corporate profits

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