Source of Stress


I got fooled again!  The title of the piece is called “EHRs are ‘a source of stress for physicians,’ AMA says” and I just knew it was the docs over at Gomerblog who had put it out.  Nope.  It was a real a real article from something called EHR intelligence.  I am not even blaming them.  It seems the idiots at the AMA came up with these pearls of wisdom.  Here are some beauties from the report:

  • Physicians who feel like they can’t deliver quality care to patients have low levels of job satisfaction, and EHRs are the biggest obstacle to providing the best possible services, argues the American Medical Association (AMA) and the RAND Corporation in a new report.
  • Cumbersome workflows and confusing interfaces are a significant source of stress for providers who want to focus on their patients, contributing to high levels of disgruntlement that may serve as an early warning of deeper problems in the healthcare system.
  • “Physicians are frustrated by systems that force them to do clerical work or distract them from paying close attention to their patients.”
  •  Physicians who have more control over their workflow and the structure of their administrative responsibilities expressed higher levels of satisfaction with their work, while a sense of fairness, equity, and communication with peers and leaders also helped to raise morale. While physicians are generally satisfied with their income levels, they strongly desire to work to the highest level of their training without being required to perform tasks that could be relegated to lower-level members of staff, such as the copious amounts of data entry often blamed on EHRs.
  •  Physicians who feel overwhelmed by their EHR systems may not be delivering optimal levels of quality care, which has a serious impact on patient safety and outcomes. Improving the EHR user experience to keep physicians working at the best of their abilities may be a crucial factor for ensuring the long-term success of the rapidly evolving healthcare industry.

Is it me or are these people just clueless?  Docs having been screaming to the rafters about this for years and somehow now the AMA just became aware?  And they needed Rand to tell them?  Unbelievable. As you can tell, it doesn’t really matter.  Nothing will change.  As the mandates increase so will the workload.  All that will happen is that the employers (hospitals) will hire more minions to try to ease the burden and will offset that by cutting the CEOs salaries.  I’m kidding.  They will cut the doctors’ pay.   I guarantee it! (homage to the dude from Men’s Wearhouse).

Douglas Farrago MD

Douglas Farrago MD is a full-time practicing family doc in Forest, Va. He started Forest Direct Primary Care where he takes no insurance and bills patients a monthly fee. He is board certified in the specialty of Family Practice. He is the inventor of a product called the Knee Saver which is currently in the Baseball Hall of Fame. The Knee Saver and its knock-offs are worn by many major league baseball catchers. He is also the inventor of the CryoHelmet used by athletes for head injuries as well as migraine sufferers. Dr. Farrago is the author of four books, two of which are the top two most popular DPC books. From 2001 – 2011, Dr. Farrago was the editor and creator of the Placebo Journal which ran for 10 full years. Described as the Mad Magazine for doctors, he and the Placebo Journal were featured in the Washington Post, US News and World Report, the AP, and the NY Times. Dr. Farrago is also the editor of the blog Authentic Medicine which was born out of concern about where the direction of healthcare is heading and the belief that the wrong people are in charge. This blog has been going daily for more than 15 years Article about Dr. Farrago in Doximity Email Dr. Farrago – [email protected] 

  6 comments for “Source of Stress

  1. Hueydoc
    September 28, 2014 at 4:46 pm

    Our “paperwork ” doubled after adopting EPIC ( Epic failure, Epic waste of time, etc..) and not only has it hit the older doctors hard, the younger female doctors with kids are all going to part time since they cannot put in 7 day a week jobs doing data entry. When we asked for scribes, one administrator was overheard saying ( privately he thought) ” Why should we pay for scribes when we can make those stupid [email protected] do it for free on their own time ?”.
    Medicine is dying a long, slow death by administration

  2. Kurt
    September 17, 2014 at 1:07 pm

    Oh, and then there is this “baloney” called “meaningful use” where one has to click the right place in order to
    get credit. Doesn’t matter I’ve been dictating this for years in the meat of the note.
    Well guess what? Years down the road when they spend a zillions dollars for all this junk, the ivory tower boys will wonder why the health of the country still stinks.
    Welllllllll, until people are held accountable for their lousy habits, nothing is going to change. One can try to educate all they want but nobody has to follow the physcian’s advice. Look at the obesity and diabetes epidemic.
    Think we’re not “mentioning” this to our patients. I curse the Academics to God everyday for this dysfunctional system.

  3. Stella Fitzgibbons MD
    September 17, 2014 at 12:52 pm

    The software we have been burdened with seems to be the product of programmers to whom “user friendly” is a cussword. The Cerner programs in particular seem designed to make as little sense as possible to anybody using them for patient care–my Tenet hospital went cheap and saddled us with a Mark One version that couldn’t even handle sliding scale insulin, and whatever seems like the reasonable way to get from A to B is always wrong. Of course hospital administrators LOVE changing things because that makes them look productive; I’m not sure how they felt about all the overtime the nurses were billing.

  4. esp
    September 16, 2014 at 7:51 pm

    I have been using this technocrap for over 15 years [not my choice] and never once do I recall anybody in management ever formally asking for ideas or opinions about it from clinicians. It is analogous to the old saw from senior residents, “If I ever see an intern who doesn’t double my workload I will kiss his feet.’

  5. R Watkins
    September 16, 2014 at 4:22 pm

    Read the actual report ( with their proposed solutions: it’s even worse than one would imagine.

    Completely clueless, bass-ackwards approach to IT, based on the ludicrous assumption that EMRs designed to work in a totally f’ed up system can ever be anything but disasters.

  6. September 16, 2014 at 7:21 am

    The entire process of making the EMR is what we at MIT used to call a “kluge” – a thing that has no truly defining purpose or overriding design goal, but is merely put together as though by accident. All that was ever certain was that people would “do” an EMR, and it has been done.
    What the thing is that has fallen off the end of the assembly line is mystifying, as though it were a square-wheeled car. Yes, of course, such a car could be manufactured.
    If one wishes to reach into the technology mirror and consider something of admirable design, one should contemplate the great engineer Mikhail Kalashnikov’s work. His rifle, designed in 1947, still remains; in fact, in a shocking display of intellectual theft, the AK-47 “Kalashnikov” is the most copied firearm in the world, and comprises 20% of all small-arms rifles in the world today.
    It is bad by many aspects – not very accurate, not very quiet, quite sloppy with the fitting of parts, and frequently built from pallet-board cheap wood deserving of the fireplace, not the automatic rifle.
    It is only good for what it is intended for – firing bullets out the front end in more or less the desired direction, and rapidly. It can be cleaned, rebuilt and reassembled by inexperienced peasants. It can be operated by children, and assembled by drunks. Given the right materials, it can be manufactured in a cave, and the ammunition in a jungle. Again, excepting the materials, the manufacturing processes required for mass-production date back to the 1870’s.
    All it does is work, and work reliably. It takes five minutes to learn how to use it, and an hour to learn how to disassemble it with no tools. A small quantity of oil and a wooden stick, and it can be field-maintained for months.
    Its resistance to operational failure is legendary – found sunk in swamps, buried in mud under tank tracks, people claim that a simple pull of the trigger will blast the mud and water out of it after a few rounds, and it’s back to its ugly old self again.
    All it does is work.
    The AK-47 is ugly; but the EMR is pathetic. $28 billion Federal dollars spent – and umpteen private sector dollars – and we have this atrocity. It’s like someone forgot to put the hole thru the barrel for the bullet to go. We should hang our heads in the memory of the engineer Mikhail Kalashnikov. He just passed away in his 90’s a few years or so ago. It’s a pity we never had him build an EMR for the Americans.

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