Can Amazon Actually Kill People by Steven Mussey MD?

The internet has become life or death to millions. This is not an exaggeration.  Our representatives in the United States Government, paid by Electronic Medical Records (EMR) software companies, mandated doctors participate in this scheme of records management. Doctors must use software, integrally linked into the internet, to provide daily care. (We still can’t share information with each other… but that’s for another rant…..)  Otherwise, Medicare will cut the pay of any doctor who chooses to stay with paper.

What if you are distrustful and want to keep a paper backup in case the EMR dies?  NO! Even my malpractice insurance carrier calls such a backup perilous and confusing.  Such duplication violates “best practices.” Use the safety tools in your computer system! “Trust us! We got your back! Paper is unreliable and gets lost!”

Yet, we do it anyway. Why?

Because the internet is a mess! Computers suddenly act strange. Ransomware predators lurk in the shadows. Sites go down without warning.  “Put your trust in the cloud! It’s the only safe way! Computer prescribing and records will keep patients safer than ever before! Don’t live in the dangerous past!”

Well, yesterday, Amazon Web Services had a huge outage. This was not simply an outage that temporarily slowed your Amazon Prime web browsing.  Companies relied on Amazon Web Services for their day to day function. Unfortunately, one of these companies was our EMR provider.  This means, at mid-day, we were dead in the water. Our schedule and all of our patient notes were inaccessible.  No medical records equals no medical care. Period. End of story. Game over!

You can’t see patients. You can’t even answer the phone! You have no idea who is walking in the door for their scheduled visit.  You might as well close the office and turn off the phones.

But we had our paper backup. This was the same paper backup we maintained despite our malpractice carrier’s warnings that we were tempting epic disasters.

So, yesterday, with my computer sitting like a gigantic paperweight for a couple of hours, I grabbed a pen and a new device called…. “paper”… and went to work.

Nobody died. Nobody got hurt.

We survived.

Amazon failed us. Our EMR failed us. Our trusty pen and paper backup charts saved us.


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] 

  9 comments for “Can Amazon Actually Kill People by Steven Mussey MD?

  1. Kathy
    March 10, 2017 at 10:26 am


    There, I’ve done my part!

    • Kurt
      March 13, 2017 at 8:52 am

      A little known fact is now a medication error can be propagated by a simple mouse click.
      In the past, at least the brain had to be engaged before moving the pen on the paper!
      (Or when dictating from the crib notes!)

      Pharmacists used to catch errors when nurses called to renew medications and would point
      out changes made by other physicians. Now, push a button and the wrong meds can be renewed.

      A well thought out electronic record assist should have been rigorously pursued instead of this

  2. Soccerdoc
    March 5, 2017 at 10:38 am

    To Pat’s point about note simplicity, I received a 6 page ER note on a 60 yo woman who slipped on black ice and lacerated her leg. No mention of size or location and no explanation of treatment. Fortunately, she passed the Glasgow Coma Screen, is not being abused at home, and does have an Advanced Directive.

    • Pat
      March 5, 2017 at 11:15 am

      That’s hilarious…

  3. Pat
    March 4, 2017 at 10:58 am

    It is incumbent on each business owner to decide what works best for him. If EMR’s are the best way to practice, then doctors would have gone to them en mass long ago. The very fact that they were mandated means they were not the best choice.

    This goes to the larger point: the central government has no appropriate role in the daily provision of health care, and will abuse that role into population control. This is not just political theory – it is practical reality. Primary care notes should be as simple as file cards: “Mrs. Smith – cough – smoker – RT rhonchi – bronchitis – levaquin, prednisone, f/u prn”. Something as tedious as Mrs Smith’s case does not deserve a page of data. The instinct of government is to control Mrs Smith, to control her doctor, and to use each party to control the other. Again not theory, that has already happened. There is nothing noble and nothing honorable about that relationship. Don’t even try to dress it up as “compassionate.”

    • Non Compos Mentis
      March 5, 2017 at 9:41 am

      Well said.

  4. drhockey
    March 4, 2017 at 9:20 am

    Dr. Mussey — been there, done that.

    Paper chart hack — break a window to get into my office.
    EMR hack — you can keep your bathrobe on while in your Moldova/China/Russia/etc. apartment.
    Which system seems more secure with less people “eligible” to hack into your patients’ Protected Health Information?

  5. HJR
    March 4, 2017 at 8:40 am

    Our inpatient EMR often goes down for hours at a time. When it happens, the administrators say “use downtime procedures” which means “fly by the seat of your f-ing pants”. Imagine covering 100 inpatients at night that you’ve never met, and you know nothing about. Mr. X’s BP is 210/110? OK, well what was it earlier today? Oh,… there’s nowhere to find that out because the system is down? Well,… what meds is Mr. X on? There’s nowhere to find that out either,… I see. Well what is Mr. X even doing in the hospital? Oh, that’s right. The H&P only exists in the computer too. Good thing nothing important is in the EMR. What could possibly go wrong?

  6. Thomas Guastavino
    March 4, 2017 at 8:36 am

    No one has ever hacked a locked up paper chart and a paper chart never crashes. Of course, the government can’t track what you are doing if you use a paper chart so they of course, prefer the computer.

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