Physician Business Ideas: The Cost of EHR Fear - Low Physician Adoption and Alienated Doctors

In response to yesterday’s blog, “Universal Electronic Health Records – The Right Thing To Do?” which questioned the value of EHRs and the right of government to impose their use on doctors, I received this comment.

Beth said...

“I have been enjoying several of your recent posts.

In regards to this particular question, when is using government force to implement a program like this EVER doing the ‘right thing’? Doesn't the means (coercion) negate whatever good might be achieved? “

“In other words, some things, because of means employed, can never be the ‘right thing’.”

To which I responded,

”There are limits to government bulldozing and to imposing forced technologies on hospitals and doctors. I'm reminded our failure in Vietnam to root out the guerillas with napalm and airpower. One critic observed, "You can't weed a garden with a bulldozer." Federal intervention into private affairs has limits.”

Then I stumbled upon a wonderful piece, "The Cost of Fear," by Rob Lamberts,M.D., a primary care physician “somewhere in the Southeastern United States. “ The piece was a blog in The Health Care Blog, one of the most widely read blogs which has been going strong since 2003. The Health Care Blog is a gathering place for Health 2.0 aficionados, who tend to believe Internet-generated data is the do-all and be-all for solving, or at least ameliorating, health care quality problems.

Rob, a devotee of EHRs and a user, says, among other things,

“My best guess is that it (Fear of misuse of computer-generated data) is the overwhelming sense of pessimism most doctors feel about their profession. Docs are second-guessed by lawyers, patients, TV shows, insurance companies, and the government. The fate of medicine is not in the hands of doctors, it is in the hands of politicians, corporate executives, and malpractice attorneys. It seems to me that the only way to avoid more scrutiny and to hang on to some control is to hold tightly to what we’ve got: our information. Once that information is on computers it is far more accessible by others, and this is a bad thing if the goal is to retain full control.”

“So are docs just power hungry, wanting total control because of their inflated egos? Some are, but most are not. Even the most technologically-minded of us, however, have an increasing unease about the intrusion of others on our ability to do our job.

I don’t want to be thinking about attorneys when I am prescribing medications. I don’t want to withhold information important from the chart because I know patients will be reading it. I don’t want to be forced to include a lengthy justification of a procedure in my notes to make the insurance company happy. As it stands, it sometimes feels like anything we include in our records ‘can and will be used against us.’ ”

“If someone like me, a physician who embraces technology, feels increasingly penned in by the increasing number of people peering at what I do, it is very understandable that other physicians reject technology outright. They’ll quit before they give up their independence.”

“Is it stupid? In some ways it is. It certainly is a rejection of the centrality of what’s good for the patient. But our system can’t afford to alienate physicians at this time. If technology is going to be pushed, there needs to be a reassurance that this won’t be used against them. I am frustrated at the lack of acceptance of technology, but even more frustrated at a system that is hostile that forces docs into this foxhole.”

Low adoption rates of EHRs may not, in other words, be due to physician technophobia, but to lack of reassurance that EHR-data will not be used against them.

To My Readership: I am looking for more work writing about health reform and innovations that would help physicians. I have a 35 year history of writing for doctors on major health system issues. If you have enjoyed my writing, please let me know of any opportunities in the medical writing or editing fields. My phone number is 1-860-395-1501, and my email is rreece1500@aol.com.