Letter: EHRs make no sense financially for doctors

On page 16 of your October 10, 2014, issue was an article with the headline, “Physician Survey: EHRs Waste 48 Minutes Daily.”

The article states a survey by the American College of Physicians found that “every respondent reported losing some time each day because of EHR [electronic health record] use,” and that the “mean loss for attending physicians was 48 minutes.” That disturbingly means that more than half of the respondents lost MORE than 48 minutes a day. That really bothers me.

Not only is our valuable time, for which we get paid, going to waste, but we are so hampered by these systems that effectively the number of patients we are able to serve in one day is significantly reduced. That, to me, translates into poorer care for those we do see and denied access to care for those we don’t. We are forced to spend more time focusing on the computer and less time communicating with our patients. 

Physician productivity has been severely impacted by EHRs as this survey so accurately displays. Before EHRs, I could easily see 32-36 patients a day. After implementation of an EHR that number dropped to 25-28 on a good day.

The really disturbing rub in all this is the effect on a practice’s bottom line. Forty-eight minutes translates into seeing four to six fewer patients a day which then translates into hundreds of dollars in lost revenue. And for all this great technology you only have to spend $25,000 per doctor outright and pay God-know-how-much monthly to “support” the system. And we all know how reimbursement has declined over the years.

This whole scenario makes no financial sense to me. It leads hard-working solo practitioners like me to throw in the towel and become an employee of a practice entity, or retire as I did.

So the conclusions of this alarming study should really upset us as they do me.

The one’s who really suffer, though, are those patients we could see in those 48+ minutes who are told we have no appointment times. It’s a darn shame. Suggestions are made to employ a scribe, which is a good idea, but I can’t recall there being any CPT [current procedural terminology] codes for the work of a scribe. Are there?

Oh, well. It’s the way of today’s medical world like it or not. EHRs and their proponents are well-intentioned, but computers do intrude on our ability to provide good care and service to our patients. I fail to see how they bring about better care other than if effective interoperablity can be accomplished. To excess, they document data adequately and accurately if input is correct. But they will never be able to replace the human factor so important in the doctor-patient relationship.

William M. Gilkison MD

 Greenwood, Indiana