Physician time means nothing to programmers and policy makers
It’s a larger symptom, I think, of the new efficiencies built into the electronic medical record (EMR) that has become ubiquitous with the world of medicine today. Information flies so fast and there’s so much of it that it’s getting almost impossible for doctors to keep up with the screen responsibilities, not to mention their care responsibilities. The EMR is no longer just an EMR.
The EMR has morphed into a scheduling agent, pharmacy, reminder pad, calculator, care pathway generator, instant messaging service, a procedure orderer-by-proxy (and guideline) and a patient messaging portal that, aside from a 400 character limit, provides unprecedented access to physician in-boxes and schedules. There are so many buttons that they no longer fit on a single screen and the allergy field no longer can be displayed as it’s pushed out of the way by the name of the patient’s insurer.
Add to this the constant and growing influx of patients (thanks to marketing pushes and programs to spur referrals), voluminous administrative meetings, and growing CME requirements, it’s no wonder many of us feel flooded. I work later than ever now thanks to these electronic efficiencies, then find myself waking in the middle of the night wondering: Did I call Ms. Smith? Did I miss something? Did I put that order in? When am I going to do those result notes?
I think I’m suffering from post-traumatic electronic overload disorder (PTEOD).
Oh sure, we could hire another guy or gal to offload some of the work — maybe even hire a wasteful manpower-intensive scribe like those that work in some ERs that click for cash – but that really won’t help stem the ongoing barrage of information that is now pummeling physicians and their care teams at an unprecedented rate.
Sadly, I don’t see this trend changing anytime soon — the business case for the EMR is just too attractive for hospitals and payers. Still, with the prospect of ICD-10 and it’s 71,924 procedure codes and 69,823 diagnosis codes (that must be paired correctly lest doctors not be paid) just around the corner, I fear that physician stress, burnout and PTEOD will only increase as we are force-fed this diet of electronic overload without any reflection of what its doing to those who provide the care.
I need another vacation.
Wes Fisher is a cardiologist who blogs at Dr. Wes.