Time for a Change

From the March 2005 Issue

From The Editor

Time for a Change

By Robin Blair, Editor

In its Jan. 31 issue, U.S. News & World Report’s cover story stopped me in my tracks. On the cover, “Who Needs Doctors? Your future physician might not be an M.D.—and you might be better off,” said a mouthful, as did “Doctors Vanish From View” and “Medicine’s Turf Wars” in the six-article special section. The gist of it was this:

First, physicians are disenchanted and dissatisfied with medical practice. They don’t have enough time to spend with patients. They are mired in paperwork and limited by managed care’s restrictions. Their business risks are great, their financial rewards aren’t and their humanistic motivations for choosing medicine as a career are less satisfied than ever.

For example, one article said that the average patient visit lasts 13 minutes to 17 minutes, and quoted a medical school professor as saying that physicians see 25 patients a day—and that no doctor can say hello to 25 patients a day. Really? Sounds like heaven to me. My average doctor’s visit consists of five or six minutes with him and two or three minutes with his medical assistant. I would estimate he sees at least 40 patients a day.

Secondly, don’t expect the new generation of physicians to put up with that. The new crop shies away from high-risk specialties like obstetrics, time-consuming specialties like family medicine and high-stress specialties like neurosurgery. What’s popular? Radiology, dermatology and boutique practices. Today’s young practitioners won’t stand for a 16-hour, always-on-call day. Many say their first priorities are their families, and work comes second—just like many professionals in many other professions.

About the same time that the magazine hit my mailbox, HMT received news from MGMA of another survey on EMR adoption, the bottom line of which was that a full 75 percent of physician practices don’t use EMRs.

We all know that no IT system can completely relieve the symptoms of inefficiency—not an EMR, CPOE or e-prescribing technology. But for Pete’s sake—IT systems do provide the best tools available to safeguard data and use time wisely. They have a clear shot at influencing malpractice insurance rates, reducing medical error rates and improving a practice’s ability to grow its business without proportionately increasing its staff expense.

Is there a physician practice left on earth that hasn’t automated its financial functions? Can you imagine a physician’s office not generating a computerized bill or having a computerized ledger to post payments to? These same physicians practices that wouldn’t entrust their financial functions to a manual system don’t think twice about using paper and pen for patient charts or a 10-pound PDR for medical reference. These are the same practices that gained national media attention last year when they began to charge patients an annual fee for their completing medical and insurance paperwork, in some cases up to $80 or $100 annually.

I have soap-boxed in this space for several years now about the need to amortize or share the high cost of implementing information technology systems in physician practices. I still support that. But when the very factors that cause doctors to rethink their career decisions, retire early, switch to boutique practices or opt for dermatology over family practice are the same factors that could be productively addressed and alleviated with IT—well, again, what’s the definition of a no-brainer?