Alert Fatigue Versus Idiot Fatigue

Exclamation danger sign

Are you ready for this?  There is again some concern for all the digital warnings being given to doctors by their EMRs (electronic medical records):

The electronic patient records that the federal government has been pushing — in an effort to coordinate health care and reduce mistakes — come with a host of bells and whistles that may be doing the opposite in some cases.  What’s the problem? It’s called alert fatigue.

Here is some more:

  • The number of these pop-up messages has become unmanageable, doctors and IT experts say, because of reflecting what many experts call excessive caution, and now they are overwhelming practitioners.
  • Clinicians ignore safety notifications between 49 percent and 96 percent of the time

Go ahead and read the rest of the article but it is meaningless.  The same idiots who are in charge will just hire “EMR Alert Specialists” who, like scribes,  will help the doctors go through all the warnings and exclamation points on their EMR records.  Think I am kidding?  I blogged about this four years ago when nurses were going through the same thing.  Read it here though the original goes back to the Placebo Journal Gazette which is gone.  It was cheaper to hire people to watch the machines who put out the alerts (bells, whistles) than to hire more nurses.

Maybe we should have less patients, which would make less records to go through?

Or maybe we just stop listening to the administrative idiots?  I call that Idiot Fatigue. And I definitely have that.


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] 

  5 comments for “Alert Fatigue Versus Idiot Fatigue

  1. Steve O'
    June 15, 2016 at 8:31 am

    Anyone who doesn’t get it yet – the MEDIAN PROJECTED SURVIVAL for ESRD patients in Japan is 18 years. In the United States, it’s 4 years. We get a “dialysis discount” of 14 years as our dialysis patients die off much quicker. At 18 years, less than 5% of our dialysis patients are alive.

    Where are the quality papers on this, the media mass movement, the outrage? It’s because dialysis is a “huge cost driver.” The Nazi’s used to euthanize their big cost drivers, but that gets you bad press. And it suffered “project creep” into a machine that killed 6-8 million people in camps. Oops.

    So we do euthanasia with seeming concern, with a steady gaze the other way at the “opiate epidemic” or “robot surgeons yay!” or “How to operate clinics at a loss.” Dialysis, shhh…

    If we don’t have the moral fiber to support human wellness and lives, we won’t come right out and say so. The dead appear sporadically here and there, grandma has an arrythmia from hypokalemia – she should have exercised more, that ESRD grandma!

    Evil hasn’t gone away. It’s become more clever.

  2. Sir Hakum of Hugo
    June 15, 2016 at 8:25 am

    File this report in the drawer marked “No Schlitz Sherlock”.

    Why oh why could someone have not taken the best paper chart processes and simply electronified them? That would have been too easy.

    I’m glad to know the computer is not sure if the Zyrtec has an interaction with paper tape or glucometer test strips.

    • Steve O'
      June 15, 2016 at 8:33 am

      HInt… computer programs only exist for the purposes they are made. EMR is NOT about clinical care, never was, never will be.

      • Kurt
        June 16, 2016 at 10:59 am


  3. Steve O'
    June 15, 2016 at 8:18 am

    “Maybe we should have less patients, which would make less records to go through?” What else could all this be about? The bean-counters figure that each patient visit costs them money, no matter whether they’re semi-public insurance companies or full-public Medicare. You don’t have to pay for an aortic valve job if nobody ever diagnoses it.

    Payers look at the waiting room as a sewer of threatened costs. That includes, emphatically, Medicare and Medicaid. If that’s the plan, more bells! more whistles! Fewer patients! say the idiots-in-charge.

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