Tying Medical Licensure to EMR


I have been blogging for years about the slippery slope of tying licensure to bullshit.   I have warned that taking Medicaid patients may be on the horizon.  Well, Massachusetts didn’t go that far but they are moving in that direction:

The Board of Registration in Medicine has finalized regulations that implement a state law requiring physicians to demonstrate proficiency in the use of electronic medical records, as well as the skills to achieve the federal Meaningful Use standard.

Under the regulations, physicians are considered to have demonstrated proficiency if they meet any one of the following conditions:

  • Participating in the Meaningful Use program as an Eligible Professional

  • Having a relationship with a hospital that has been certified as a Meaningful Use participant. This relationship would be satisfied by any one of the following conditions:

  • Employed by the hospital

  • Credentialed by the hospital to provide patient care

  • Having a “contractual agreement” with the hospital

  • Completing at least three hours of accredited CME program on electronic health records. Such a program must, at a minimum, discuss the core and menu set objectives, as well as the clinical quality measures for Meaningful Use.

  • Online CME courses on EHRs from the MMS are available here.

  • Participating or being an authorized user in the Massachusetts Health Information Highway (the state’s official health information exchange)

Why the hell should licensure depend on “meaningful use” when it hasn’t proved to be mean anything?  Look at those bullet points.  They are tying a doctor’s license to his/her relationship to the government or hospital!  Moronic. Idiotic.  I am blown away.

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] 

  15 comments for “Tying Medical Licensure to EMR

  1. Chris
    January 8, 2015 at 3:14 pm

    I regularly use the term “Meaningless Use” when talking with others about this issuel. I dont have anything against a computerized medical record, its all the extra bs that the government wants me to do with it that have nothing to do with taking care of patients.

  2. Ray
    January 2, 2015 at 8:10 pm

    Wow! Hospital employment. EMR. Meaningful use. 1984 George Orwell. I clearly remember the insidious EMR discussion and the “quality” push. EMR will make us better. Just the contrary. It enabled the government and hospitals to monitor and control physicians. George Orwell called it. Patient care suffered, doctor/patient relationship destroyed! This is about control. We physicians did create this problem in part with our apathy. Get real with yourself doc’s! Who is in control? You? Hah? That is laughable, we all know that. How did this happen? We gave up our autonomy for comfort, or stability, or the almighty dollar. We are paying the price of a generation of physicians and American medical leadership that decided that selling their medical practices to hospitals or insurance companies was OK. We lost our leverage and our identity. Now we must take it back. I agree that an organised movement is the only leverage we have. It seems that the tipping point for national healthcare is approaching. Get politically organised and motivated or accept what the conquerers give you after defeat. History suggest’s you will be handed your head.

  3. R Watkins
    January 2, 2015 at 1:39 pm

    “The MMS (Masschusetts Medical Society) is grateful to the Board’s chair, Candace Sloane, MD, and its members, who voted to implement the regulations in a responsible manner”

    Our profession has never been lacking for whores.

  4. politovski
    January 2, 2015 at 12:57 pm

    just wait until we are expected to take 25% medicaid to qualify for a license renewal!
    won’t that be fun….

    • Pat
      January 2, 2015 at 3:31 pm

      I’ve been predicting that for years; the feds will use the threat of withholding funds (as was done in 1984 to force all states to “voluntarily” raise their respective drinking ages to 21) to encourage states to enforce the collective. Initially the states will force all docs to participate in Medicare/-caid; later they will require so much of a doc’s panel to include the dependent government patients. Doc’s will be forced to take so much Medicaid/-care, and the smart ones will start with creative scheduling, say scheduling Medicaid physicals every Thursday from 3:30 to 4:00. Eventually new auditors will be called in to tighten that up, and so on. As a profession aspiring to noble purposes, we are all but done. We are becoming so rapidly nationalized that physicians should form an actual nationwide union – suck it AMA – and begin to credibly threaten strikes. And yes, that goes against everything I have every believed, but honest men cannot survive in a dishonest system.

      “Who is the public? What does it hold as its good? There was a time when men believed that ‘the good’ was a concept to be defined by a code of moral values and that no man had the right to seek his good through the violation of the rights of another. If it is now believed that my fellow men may sacrifice me in any manner they please for the sake of whatever they believe to be their own if they believe that they may seize my property simply because they need it – well, so does any burglar. There is only this difference: the burglar does not ask me to sanction his act.” ~ Atlas Shrugged.

      • RWatkins
        January 3, 2015 at 3:05 pm

        Do you think all workers – teachers, policemen, automobile workers, etc. – should form nationwide unions, or just doctors?

        • Pat
          January 3, 2015 at 6:38 pm

          Disclaimer: I’m largely opposed to public sector unions, especially regarding benefits. That said, a collective of federal gov’t-crony corporatism-do-gooder advocacy groups, and greedy voting blocs are rapidly removing all choice regarding our ability to work. I would (seriously) live to hear an alternative – got one?

          • RWatkins
            January 4, 2015 at 2:42 pm

            I’d start with strong unions (both public and private sector), and enormously more strict restrictions on campaign spending/fundraising. Both have been progressively undermined since 1980, and have given us our current near-oligarchy.

            But I imagine both those ideas are anathema to libertarians/Randinistas?

        • Pat
          January 5, 2015 at 9:06 am

          You imagine correctly. Those “solutions” would do nothing to fight/reverse the current problems, and would only further empower the very forces that are rapidly enslaving the medical industry.

          • Rwatkins
            January 5, 2015 at 11:31 am

            Empowering the workers (docs and nurses) by allowing them to unionize will make the insurers, hospital corps, and big pharma stronger? I don’t see it.

      • Pat
        January 5, 2015 at 1:56 pm

        So-called campaign finance reforms have only served to consolidate the government’s hold on power, which is the problem. The problems caused by crony-corporatist hospital and big pharma groups pale compared to those caused by government force. The Massachusetts medical board passing regulations to force doctors to use EHR’s has little or nothing to do with hospitals and drug companies, and everything to do with collective force.

        • RWatkins
          January 7, 2015 at 12:40 pm
          • Pat
            January 8, 2015 at 1:17 am

            Certainly a thought-provoking piece, thanks for sharing it. The “Ayn Rand sociopath” crack was obviously ignorant from an obvious pro-union author, and while both Big Biz and government were the stated culprits, the tone was certainly tinged more anti-business.

            The effects and attitudes of the medical community entering into a union were both encouraging, and frightening. Looking into that abyss doesn’t make me feel much better than the alternative of our present course.

  5. Steve_O'_
    January 2, 2015 at 10:25 am

    I agree with Sir LOL above. The independently practicing physician, providing direct patient care, must be brought under control. That is why I have been so pessimistic about DPC – it’s so superior to the mediocre pap doled out to everyone else, it must be trashed.
    Along with videotaping the encounter into the medical record, and the RFID chipping of patients, EMR & MOC certification of all physician-drones is on the way. Suggesting these things twenty years ago would have gotten you a big ol’ shot of Haldol in the bum – how paranoid!
    Our society now seems to find the private meeting of physician and patient together somewhat terroristic – it reeks of sedition, and who is in control of the situation? Nobody?
    American Public Medicine is on the way to catching up with American Public Education.

  6. Sir Lance-a-lot
    January 2, 2015 at 6:48 am

    Frickin’ scary.

    They’ve painted a big red target on you, Doug, the independently practicing physician, former backbone of American medicine, and greatest threat to the current Medical Industrial Complex.

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