Doctor Quits Practice Over EHR Use

I got sent this interesting article that starts by talking about a doctor who leaves his medical practice because of the 3 physician group’s EHR system. The complaint being that patient wait times were 1-2 hours. The major problem seems his inability to type and to learn the new system.

Did no one offer this doctor a scribe or voice recognition (although this would have probably even been harder for him) to make his EHR use easier?

Reminds me of the opposite side of the coin as well. A medical student friend of mine hates when he has a rotation in a practice that doesn’t have an EMR. Mostly because he can type so much faster than he can write.

About the author

John Lynn

John Lynn

John Lynn is the Founder of the 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.

8 Comments

  • Wow. Well I guess it is bound to happen here and there. What troubles me the most is why wasn’t that addressed during the implementation. Any good consultant, assuming they were even using one, would recognize this and at least try to come up with alternative solutions so that doctor could make use of the EMR.

  • John, unfortunately, this is not an uncommon occurrence. As trainers and coaches, we see physicians that simply don’t have the computer skills necessary to navigate the EMR. Albeit, these are mostly older docs who would rather retire than change the way they have practiced medicine their whole career, but I’ve seen younger docs “fuss” as well.
    What is sad is that we’re losing all those years of experience because no one chose to allow exceptions to the “rules”. Scribes are a valuable resource for physicians who can’t or won’t use the EMR. One-on-one coaching is a valuable tool, as well. Sometimes just giving a little extra training/coaching time so the physician can get comfortable with the technology can make a difficult situation turn into a positive one.

  • Great comments and it is sad that it happened. Although, I also had a nurse that I worked with on an EMR. She was perfectly capable of using it. In fact, she did quite well. However, she just didn’t enjoy it. Luckily, she didn’t leave the profession. She just moved to a clinic where it was on paper.

  • There was congressional testimony from the Air Force about the problem a couple of years ago. Seems that several docs left the service and complained about the military’s EMR during their exit interviews.

    It’s not nearly as simple as the typing. The overall productivity hit averages around 20%, 6 months _after_ completion of the implementation. The loss of face time with the pt is disturbing to many physicians. The disrespect inherent in requiring a physician to act as a data entry clerk (what other 6 figure income in the organization – except IT folk – is required to hunt and peck at a keyboard all day?) The inflexibility of some systems (and the associated personal liability) in forcing the physician to click “yes” in order to continue, when “yes” isn’t the correct or appropriate answer, but the system won’t accept “no.” Alert fatigue. CPOE hassles. Repetitive medication reconciliations on hospital ward transfers. Inflexible, inviolable DSS. Inability of some systems to support graphics (lots of surgeons like to draw stuff for patients.) Sit down; type; stand up; examine the patient; sit down; type; repeat ad nauseum. The list could go on for a long time…

    And what no one seems to care about is that almost every one of these issues results in a _personal_ liability for the physician. Oh yeah – to quote recent radio ads from Dragon Simply Speaking – “type-ing gets in the way of think–ing.”

    EMRs have great potential. EMR input methods are inadequate to the tasks a doctor performs all day.

  • Al,
    Great analysis. I’d be interested to see that testimony. Do you know if it’s available online and where I could find it?

    You do describe some of the major challenges to adoption. The data entry clerk is an oft sited one. Although, I’m not sure your description of them hunt and pecking the keyboard all day should be accurate. Anyone that allows that to happen has failed in their EMR implementation. There are other solutions to solve the doctor hunting and pecking problem.

    In fact, I love when I talked to a med student friend of mine who talked about how he HATED when a doctor didn’t have an EMR. Mostly because he could type his notes a lot faster than he could write them. So things are changing. Not to mention there are other solutions.

    I’ve found that in a reasonable EMR implementation (which some just chose bad EMR software or implemented it poorly) the people that complain about all the clicks were the same ones complaining about all the things they had to document on paper too. If we got rid of the various billing documentation requirements, there would be a lot less clicks in EVERY EMR.

    This said, I do agree with you that EMR input methods can still be improved and must be improved to accelerate EMR adoption.

  • I didn’t find the congressional record with a quick search, but I found a reference to it – http://www.usmedicine.com/articles/electronic-records-system-unreliable-difficult-to-use-service-officials-tell-congress.html.

    Your med student friend sounds like one of the new breed of doctors that are coming through the pipeline – very computer-savvy, very good at taking orders from patients, but needs serious help with his integrative skills. For a while the buzzword was “multitasker”, but in reality these students tend to be rapid “task shifters”, which is subtly and inefficiently different. Writing a note after the fact doesn’t help the patient! He needs to learn to think on the fly. But he’ll figure that out for himself in residency (maybe after he gets sued!) when he has real patients and real responsibility staring him in the face, and wanting answers NOW. Hiding behind the computer screen is a time-tested tactic that most interns tend to use for about their first month or so out of medical school; then they get slammed, either by a patient or their attending physician.

  • Nice generalization. Reminds me of the generalizations that are made about older doctors as well. Turns out they’re both generally true.

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