EMR and Older Doctors

Dr. Michael Koriwchak recently did a great post about implementing an EMR in a practice with an older physician. He does a great job analyzing the challenge that a group practice faces when one of the older physicians (I prefer mature physicians, but he said older) is the “lone hold-out.” Here’s his suggestion which is really valuable:

So the older doc who claims to be ready to retire may not retire as soon as he thinks. So do you let him opt out of EMR or not?

I would be happy to let him opt out of EMR…provided he commits in writing to a retirement date and allows the practice to begin making plans to recruit a replacement physician. The date would be fairly soon, no more than 18 months in the future. If he fails to retire by that date he would begin incurring costs related to EMR, both in take-home pay and retirement buy out.

This approach avoids the nearly impossible task of trying to calculate the return on investment “break-even point” for an EMR purchase, as many authors try to do.

This is definitely an interesting challenge. In response to Dr. Koriwchak’s post I wrote the following about the mature physician population and EMR:
No doubt there are a lot of interesting dynamics like this in a group practice. I’m glad you’re bringing them to light.

What I’ve found interesting in my experience is many of the really close to retirement age doctors that I know are actually quite happy to adapt to an EMR. They have some learning curve, but they aren’t generally the problems (although there are exceptions).

I’m not sure exactly why, but I think it might have to do with demeanor and their easy going personality and love of what they’re doing. If they didn’t have these qualities they would have retired from the medical profession already.

The hardest ones are the middle to upper age doctors that have 5-10 years before retirement. When they don’t want an EMR it’s an ugly situation.

Tell me about your experiences with mature doctors and EMR. Any secrets to be shared?

About the author

John Lynn

John Lynn

John Lynn is the Founder of HealthcareScene.com, a network of leading Healthcare IT resources. The flagship blog, Healthcare IT Today, contains over 13,000 articles with over half of the articles written by John. These EMR and Healthcare IT related articles have been viewed over 20 million times.

John manages Healthcare IT Central, the leading career Health IT job board. He also organizes the first of its kind conference and community focused on healthcare marketing, Healthcare and IT Marketing Conference, and a healthcare IT conference, EXPO.health, focused on practical healthcare IT innovation. John is an advisor to multiple healthcare IT companies. John is highly involved in social media, and in addition to his blogs can be found on Twitter: @techguy.


  • I thought about blogging on this and my perspectives in dealing with several older physicians in my community, but I didn’t want to be politically incorrect. I also didn’t feel I could defend any of my strong suppositions with hard facts, so I chickened out.

  • You have to be brave to be a blogger;-)

    I don’t usually say old doctors, but that’s the term he used. Someone on this website taught me to call them “mature doctors” or was it “seasoned doctors.” You definitely have to be careful.

    Plus, I think my caveat is fitting. There are some amazingly impressive older doctors who are fantastic with an EMR.

  • I was surprised to work with several older docs, some that were not very technical at all, that were implementing EMR solutions. When I asked them why they were going through the process at this point in their career, they said it would increase the value of their practice when they sell it. I’ve also worked with group practices with physicians that spanned all age ranges. The older physicians were not totally on board with the decision to implement EMR but were going along with it for the good of the practice and best interest for the younger doctors in the practice.

  • I almost don’t want to bring this subject up, but someone will eventually. Scribes. A term that refers to a resource that shadows the provider and makes all EMR entries for the Provider.

    I want to go on record saying that I have very strong opinion here. There are VERY FEW situations in which I would consider using scribes: ambulatory setting where the Provider will leave within 18 months as described above, inpatient Operating Room or Emergency Room. I believe strongly that use of scribes in any other case is counter productive. (I can understand the argument that a Provider sometimes needs hands free in a critical situation like to hold your heart valves together.)

    Lasting adoption and ROI do not generally materialize for an organization that allows Providers to opt out under circumstances other than those mentioned above.

  • Brian,
    There are some very generous and kind physicians that care about the others in their practice. Thanks for reminding us.

    Another situation where I think a scribe is perfect is a male GYN. I met one who needed another person in the room with him to do the examination and so it was a perfect fit for that person to be chaperon and scribe (among other things).

  • As I noted to Dr. K’s original post on the other blog one reason the older/seasoned/mature doc is slow to implement an EMR for his small practice is because he’s the owner and doesn’t see how the value an EMR implementation’s cost and lost revenue during spin up will measure against ROI needs to meet the investment hurdle expense from his bank.

    Young doc junior partners or employee docs don’t see the books.

    In any case … as I said over there too … I don’t see how a single hold out slows implementation for a group where all have a voice. At my wife’s cardiology practice only 8 of 12 of the cardiologists and half the ANPs have changed their practice methods committing to the NextGen EMR. Those who have embraced the change include the two most senior (and oldest) partners and both docs who just left their fellowship programs. And my wife who is the senior ANP.

    So it ain’t age. It’s about deciding to make a change to improve your practice when the numbers are right.

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