Commentary

EMRs: Tyranny vs triumph


 

I’m a rural family doc and employing RNs to make EMRs work in my practice is not financially feasible (Success with team care. J Fam Pract. 2013;62:225). Neither is employing 2 medical assistants per physician. So I end up taking up the slack. Because of the EMR, I see 2 or 3 fewer patients per day and do 3 to 4 hours of extra data entry at night—with no proven benefit for the patients.

Perhaps we should have insisted on evidence that EMRs work prior to mandating them. Team care indeed!

Frank Moskos, MD
Canton, NC

I’m proud of the fact that I have sufficient time to see 30 patients a day, and—with the use of EMR templates and open text voice-activated dictation—get home no later than 6:15 pm.

I bring a laptop on a mobile stand into the room so I can make eye contact with patients while I review their history. I complete prescriptions and test ordering in the room with the patient, then dictate and enter the data into templates on a desktop with a secure line from my office. This satisfies P4P metrics, meaningful use criteria, and National Committee for Quality Assurance standards.

Patient satisfaction has little to do with technology and much more to do with maintaining eye contact, listening without interrupting, and demonstrating respect for what the patient has to say.

Andrew Selinger, MD
Bristol, Conn

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