Commentary

End EMR tyranny!

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Although electronic medical records (EMRs) were initially touted as a means of greater efficiency and streamlined workload, physicians are now required to use them not only to document patient care, but to enter all orders, medications, referrals, appointments, medical updates, and billing codes. It should come as no surprise, then, that a new survey by AmericanEHR Partners finds physician satisfaction with EMR systems on the wane (www.americanehr.com/about/news/).

If the EMR burden is bringing you down (and “meaningful use” is making it worse), you’ll be interested in what Dan Sweeney, a family physician of 27 years, had to say on the matter. He wrote the following “Declaration of Physician Independence” on a day when 2 of his long-time patients said they would not be returning; the wait time at his practice (more than an hour and a half that day) had simply become too much.

When in the course of medical practice it becomes clear that patient care and physician and patient satisfaction are at all-time lows, it is time to declare an end to unrealistic burdens that hinder our ability to provide compassionate patient care. We are expected to serve 2 masters: our patients and our EMRs. But we cannot serve both. We can complete the EMR during a visit (and forego adequate patient counseling). Or we can interact humanely with our patients—listening to their stories, answering their questions, and ending each visit with thorough instructions—and spend 2 hours each evening finishing documentation (leaving little time for our families).

I therefore declare:

  • Completion of the EMR will no longer be the primary focus of my time with patients. I will attend to appropriate EMR functions during patient encounters, reviewing relevant information and completing tasks as appropriate. This will be accomplished with the aid of voice recognition software and transcriptionists.
  • I will schedule adequate time for each patient.
  • I will no longer succumb to the pressure to add more patients to my already overbooked schedule.

To make these declarations financially feasible, Dr. Sweeney continued:

Family physicians will provide medical homes for our patients and be paid based on the number of people we care for and quality care standards, not by piecework. Relative value units will be banished forever as the measure of our productivity and our worth as physicians.

Provocative stuff.

So where do you stand on EMRs? Have you found other ways to spend quality time with patients, fulfill the myriad EMR requirements, and maintain a fulfilling family life? Have you written declarations of your own? Let us know what steps you’ve taken to end EMR tyranny. E-mail me at the address below.

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