The practice of medicine has become frustrating and painful, thanks to Congress.
Once upon a time, nothing in the exam room was more important than the patient. Using years of training and experience, your doctor would listen carefully as you shared the reasons why you were there. But today, the exam room has a distracting intruder. Your doctor’s eyes and attention are too often focused on a computer screen — the government-mandated electronic health record (EHR).
Third parties — government agencies, health plans and health IT technology companies — are using the EHR to disrupt and exploit the patient-physician relationship. To get paid, doctors must spend long hours clicking boxes in the EHR and sharing patient data with outsiders to prove compliance with the demands of these third parties. Meanwhile, patients lose the time, attention and confidential relationship with their doctor that they need and deserve.
Physician frustration is real. As one doctor wrote, “The Electronic Health Record they have in place makes me so slow and inefficient I want to scream when I come to work every day. … I am so frustrated and just want to walk away … I feel trapped and betrayed. I did not go to medical school to sit on my butt for four to six hours a day doing data entry in a computer.” A 2016 survey by The Physicians Foundation found 48 percent of physicians are considering an exodus from patient care or a drastic reduction in the number of patients they see.
Studies find deep physician dissatisfaction with the government-certified EHR technology (CEHRT) they’ve been forced to use. The most frequently cited reasons, according to a 2013 survey, are lost productivity due to documentation demands (85 percent) and seeing fewer patients (66 percent). In short, physicians who trained 11 to 17 years to care for patients have become data entry clerks for government agencies, health plans and the health IT companies that work for them.
In a 2018 survey, 40 percent of physicians said EHRs have more challenges than benefits, and 59 percent said EHRs need a complete overhaul. Patient safety is also a concern. As Modern Healthcare reported in 2015: “In 2012, 5 percent felt that EHRs increased errors versus 12 percent today.”
EHR problems are longstanding. Writing in the Wall Street Journal in 2012, Ross Koppel and Stephen Soumerai called EHRs “generally clunky, frustrating, user-unfriendly and inefficient.” In 2013, physicians blamed EHRs for lost productivity. In 2015, Dr. Koppel shared a list of the essential patient information often hidden by the EHR. In 2016, Suzanne Koven, MD, said EHRs are not built to tell the patient’s story. In 2017, a group of health care CEOs identified EHRs as a contributing factor to physician burnout, saying EHRs have “radically altered and disrupted established workflows and patient interactions [and have] become a source of interruptions and distraction and are very time intensive.”
For example, Contra Costa County, California, spent $45 million on ccLink, an EHR system to integrate all the county’s health departments. In 2012, Doctors called ccLink “clunky and time-consuming, designed more for bureaucrats than physicians.” Its systemic failure crushed morale. Eleven weeks into implementation, every doctor had considered leaving — and six physicians had left for good. The workability problems of EHRs continue. In a 2018 survey, one physician said EHRs could be improved by creating one “by and for physicians, not administrators and technogeeks.”
Doctors did not install these EHR systems to deliver better care. Their primary reasons include regulatory compliance (56 percent) and qualifying for federal EHR Meaningful Use incentive payments (40 percent). Doctors who fail to install and “meaningfully use” CEHRT are penalized with reduced Medicare payments.
Today’s EHR is not what patients think it is. It’s not a computerized version of a paper medical record. It’s a data-collecting surveillance system imposed by Congress for purposes that have nothing to do with patient care and everything to do with outsider control of the exam room.
This intrusive system is causing physicians — the only person in the exam room with medical training— to burn out, retire early and leave their patients behind. Congress must end the EHR mandate before it’s too late to save America’s physicians and patients from this dangerous intruder.
