Under My Skin

Damned documentation


“In principle sure,” she says. “But in practice what happens is this: Somebody wants to make any change – to add a relative, upgrade to a newer checking account. Even if they’ve been our depositors for 20 years, we have to ask them to produce all kinds of personal information for us to show regulators if they ask if we know people we’ve known forever.”

“Do the regulators ever ask?”

“Of course not,” says Marina. “But we have to fill out the forms, which take all day.”

Dr. Alan Rockoff, a dermatologist in Brookline, Mass.

Dr. Alan Rockoff

Sounds about as useful as Medicare Wellness Visit forms.

It’s everywhere, folks. Bureaucratization is pervasive. No one can escape. Where is Franz Kafka now that we need him?

We in medicine know this all too well, of course. Perhaps the leading cause of physician retirement is introducing EHR into the institutions they work at.

There are, of course, always reasons and justifications for bureaucratic rules. You know them all, and it doesn’t matter. Fish gotta swim and clerks gotta file. Besides, it is now an article of faith that from large data sets shall go forth great wisdom. In precision medicine. Also, in kindergarten.

Sorry, but I have to go. I’m doing my charts, and there are templates to paste and boilers to plate.

As the apocryphal cardiologist may have said, “Hey, things could be worse. I could be younger.”

Dr. Rockoff practices dermatology in Brookline, Mass., and is a longtime contributor to Dermatology News. He serves on the clinical faculty at Tufts University, Boston, and has taught senior medical students and other trainees for 30 years. His second book, “Act Like a Doctor, Think Like a Patient,” is available at amazon.com and barnesandnoble.com. Write to him at dermnews@mdedge.com.

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