I had an interesting phone call last week from an ENT doctor who had received my office note for a patient and wanted to run his proposal for surgery by me before proceeding. The patient in discussion needs a thyroid surgery for a suspicious appearing nodule, and the surgeon and I both agreed that due to the other nodules present the patient should have a complete, as opposed to partial, thyroidectomy.
Then he moved on to asking me about my EMR system, Practice Fusion, and how I liked it. After sharing a lot of information (okay, I talked his ear off, it’s hard not to when you’ve evolved a lot over a relatively short time, relatively speaking and are excited about your progress), we then moved back to to why he was asking about my EMR in the first place.
He liked the format of the note I sent to him and wanted to know more about what it was like for me to use it in my practice. Specifically, he liked that my note appeared like an authentically-written note that a human doctor put thought into rather than something a nonhuman computer spit out after clicking off some check boxes. He mirrored exactly what I have always personally felt. I want to generate notes that reflect well on me personally and the training I received at places like the University of Pennsylvania and Johns Hopkins. But, no matter where one received one’s training, as long as a good training has been received, you want to look like a good doctor to your peers. Forget what the patients think in this case. They’re not going to be the ones not referring you more patients, if you’re a subspecialist, or the subspecialists not referring their patients to you (if you’re a PCP) when the patient is looking for a new primary care doctor. Whether this concern has any validity or is purely psychological remains to be seen.
But even more to my point, many doctors are already demoralized enough into feeling like McDonald’s workers in a system overrun with never-ending patients and the pressure to see as many as possible. Giving them McDonald’s quality EMR systems that generate notes difficult to look at – on many levels — is a bad approach.
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 and opened The Washington Endocrine Clinic, PLLC, as a solo practice in 2009. He can be reached at doctorwestindc@gmail.com.
Great post. It’s prompted an idea that I think could go over really well. I’ll have to email it to you and see if you want to participate.
Ooh… You’ve peaked my interest!
[…] The article linked at the end of that tweet is a pretty interesting read. The author compares the eloquence of a dictated note versus one from an EMR. It was an interesting read since the author was a self proclaimed lover of their EMR. However, they weren’t a big fan of the EMR notes (unlike the Happy EMR Doctor who had someone praise his EMR note). […]