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My medical group (for 40 years) sold itself to a local medical center a few years ago. Now, last March 30th they “rolled out” their latest EMR implementation. I had occasion to visit my PCP last week. I had to wait an hour and a half beyond the scheduled appointment time, the reason, the harried physician told me was “computer problems.” And it’s been that way almost from the inception of EMRs. He has little time to go over what’s ailing me because he’s busy pounding away on the fancy terminal that’s been placed in each examining room. Doctors have become record keepers, this system is a government nightmare.

My PCP still uses the paper method. He is getting up there in years but still stays on top of the medical knowledge. He saved my life some years back and he did it without a computer. He is very anti-Obama and said he will keep on practicing his way and not Obama’s way even if they try to take away his license. Bty, last time I saw him, my folder was more than the 4 inches they were talking about in the article but he had no problem diagnosing my problems and taking care of them.

It’s a nightmare. I’m not sure how I’m still getting paid, but I haven’t switch over yet. When forced to, I’ll retire or go do some locus tenens rent-a-doc work.

I’m in a small, solo, end of career psychiatric private practice. This sort of system is anathema to the sort of patient-centered practice I conduct. I really don’t care much that others think this is a great leap forward. It will not work well for what I do, and I resent the idea that I should go along with forced into this model.

I frequently hear my patients complain about the sort of impact this has on their time with their doctors in other specialties. The doctor spends their whole time looking at a computer screen and making data entries on the keyboard, rather than discussing matters face to face with eye contact as any human being might.

From my side, when I get records from other doctors, for instance a progress note from a recent visit, it used to be a succinct one or two pages. Now I get 6-10 page tomes with so much useless info that I seldom even bother to take the time to review it unless it is essential to do so. The darned things are full of errors because no one has the time to go back and proofread their typing and dictation and use the system to make corrections.

On occasion I will go do some locus tenens work at a hospital or clinic who uses one of these things. It is a nightmare.

RecentlyI got an ad from a VA hospital looking for a locus tenens shrink to come fill in for a while. Among the non-requirements to go there and work were board certification, a license in that state, and certification in either advanced or even basic life support - but the one requirement for the doc was the ability to type 30 words per minute! I kid you not. That’s the focus. Data entry. The science and art of medicine be damned. No thank you.