More than half of physicians are feeling burned out, and onerous, punitive federal mandates on electronic health records (EHRs) are one of the biggest reasons, reports the Chicago Tribune on Dec 12. Many family physicians are contemplating early retirement, as “busy work” adds hours to their work day.
Doctors are not anti-technology. Physicians usually embrace technology “at a blistering pace,” says AMA president Steven J. Stack, M.D. The AMA blames lack of proper coordination and unrealistic requirements for EHR woes. It calls for more “flexibility” in stage 3 “meaningful use” requirements, which are even worse than the stage 2 demands that only 12% of eligible physicians have met.
“EHRs are supposed to be a cure-all for inefficiency and medical errors,” states AAPS Executive Director Jane M. Orient, M.D., “but the costly, clunky systems that the government demands are worsening the problems and even driving some software experts back to paper.”
In an AAPS internet survey of physicians and patients, more than 80% of 571 physician respondents said that the EHR impedes patient care, and 47% says it endangers patient safety. Fewer than 6% responded that “on the whole, it improves patient care.” More than 63% said that it compromises confidentiality, and 76% said that it is “a cash cow for data miners.”
Responses from 100 patients were also highly unfavorable: 83% said the EHR compromises confidentiality, 62% that it is a cash cow for data miners, 52% that it compromises patient care, 45% that it endangers patient safety, and only 8% that it improves patient care.
Of 305 comments, very few were positive. Many complained of inefficiency and loss of productivity: “I am now about 30% less efficient that I was, even though we are now using scribes.” The EHR often facilitates errors. One physician complained: “I have made more errors since our conversion to the EHR than in the 38 years previous to that time.”
Physicians do not trust the accuracy of the records: “Electronic medical records are really electronic medical lies.” One observed that “mistakes cannot be corrected or deleted, just ‘hidden,’ according to our IT folks.” One patient complained that the EHR has pediatricians asking inappropriate questions of unaccompanied 13-year-olds, and recording potentially damaging statements. “They make it imperative to teach kids that they should ignore or dissemble when people ask them inappropriate questions.”
The EHR also makes it difficult to find important data in a mass of irrelevancy, many reported.
“The federal government should have no role in telling how physicians how to keep their records,” Orient said.
The Association of American Physicians and Surgeons (AAPS) is a national organization representing physicians in all specialties since 1943.