Quantity vs quality: keeping America’s doctors back with MU regulations

I read the following post on Saturday over at TheHill.com.  I have to quote from the article here because it’s such a perfect setup for what so many doctors feel about meaningful use/MU.  Warning:  possible ravings of a complete lunatic coming at the end.

“Small medical practices warned Congress on Thursday that health information technology risks being less than useless if it’s designed to meet bureaucrats’ arbitrary standards rather than the needs of doctors and patients.

Testifying at a House Small Business healthcare subcommittee hearing, the CEO of HIT Services company Ingenix said cost isn’t the main reason physician’s offices are struggling to make the switch to paperless. Rather, Andy Slavitt testified, the “purchase and design of technology (…) have taken a back burner to all of the compliance reporting requirements” needed to qualify for federal incentive payments.

“Today,” Slavitt said in written testimony, “the end-users, doctors and patients, are further away than ever from system design, because new product development is focused on satisfying those regulatory hurdles, rather than on simple innovations that improve productivity.”

I could not agree more.  The U.S. federal government, in the form of HHS and CMS, is basically hijacking the doctor-patient relationship by giving doctors extra steps to do during office visits.  The way I see it, if CMS and HHS are so hellbent on puppetmastering the show and making doctors into mere data-reporting automatons — which, I have to tell you, PQRI reporting felt an aweful lot like — then I suggest that they take an even fuller responsibility for providing the healthcare to the patient themselves.  After all, what do they need doctors for if they can practically write the script for the visit?  With the increasing number of MU requirements that have to be incorporated into each visit — to basically “help” doctors “do a better job” — it begs the question “Where will it end?”.  Is it much different from an organized crime boss telling me, “Do this… or we’ll hurt you?”    As MU progresses into stages 2 and 3 — I’ve said it before and I’ll say it again — I can’t wait to find out what my CMS-participating peers will end up dealing with.

It all reminds me that I didn’t go to medical school because I wanted to become a data collector for Uncle Sam.  Call me old fashioned, but I actually like having enough time to to listen to why the patient really came to see me today.  However, for the government, apparently, the numbers are more important.

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.  He can be reached at doctorwestindc@gmail.com.

About the author

Dr. Michael West

Dr. Michael West

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 in 2009. He can be contacted at doctorwestindc@gmail.com.

4 Comments

  • Dr. West, I totally understand your frustration but shouldn’t adoption of an EHR – along with some adjustments to the operational workflow of the practice – allow you to spend more time with your patients?

    I’ll give you a quick example. I took my 7 month old in to see his doctor recently. Over the weekend he spiked a fever so we took him to the after hours clinic for treatment. Sitting the exam room, my doctor asked me what the clinic told us, what drugs they prescribed, etc. Asked ME! Needless to say, the results were not in my son’s primary chart. So he had to leave the waiting room and wonder around trying to find out where that information was. Theoretically, if he had an EHR and was using it he could have seen the full record, including the care provided by the after hours clinic. Tests that were run, scripts written, etc. He would have provided better care and would have also prevented me from thinking that I need to start looking for a new pediatrician.

  • An EMR is not more efficient than paper charts at allowing more time for talking with patients as far as I can tell. What it does do is organize all the information in one location so that the disaster you wrote about above never happens to me or any of my patients.

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