Your Voice: Stop hating EHRs and do this instead

 I am writing to say how much I enjoyed Eugene Eisman’s article, “How I learned to love my EHR and spend more time with patients” (January 10, 2017).

As someone who just turned 65, and has been in solo internal medicine practice for 37 years, I appreciate Dr. Eisman’s attitude.  I started with my own self-programmed EHR, that I carried on a laptop room to room, until better products came on the market in the late 1980s.  

I now pay a nominal fee per year for my software and don’t have to put up with any advertisements.  As with Dr. Eisman, I don’t use the software as designed, but to improve patient care.  I can make complete notes for myself and consultants in seconds.  I almost never type in front of the patient, and complete each patient’s note before the next patient arrives.  

To keep my overhead low and myself on time, I escort the next patient back to my single exam room when I am ready. This approach makes medical practice pleasant, low stress and very satisfying.  The only thing my approach won’t do is make you as much money.

Keep your overhead low, live within your means and enjoy your patients.

George W. Groth, MD

San Diego, California

Families present lawsuit threat 

In “Malpractice Pitfalls: 5 Strategies to Reduce Lawsuits Threats” (November 10, 2016), your comment about how a family member might instigate a lawsuit deserves further discussion.

Indeed, despite a physician’s sincere contrition for an error, a family member who lives hundreds of miles away, who has never met the doctor and who may not have seen the patient in years, can in just a few impulsive seconds and with just a few inconsiderate words, instigate the threat of a lawsuit against the physician that, more often than not, is unjustified.

When a family member, whether unintentionally or otherwise, makes negative comments about a doctor’s capabilities or about his or her personality, they plant seeds of suspicion and distrust [in the patient] that may override years of confidence and goodwill. 

It is impossible to know how frequently this happens, but I suspect it is more than one might expect at first thought. There is no way to protect against this except by ensuring that the sincerity and apology expressed are truly heartfelt.

Together with a little luck, this approach may save some physicians from unwarranted lawsuit threats.

Edward Volpintesta, MD

Bethel, Connecticut

Holding out hope for more states to allow e-prescribing

I was both pleased and frustrated to see the article “Is electronic prescribing a potential solution to the opioid crisis? ”(January 10, 2017).

I’ve wondered for years why this isn’t an option. Surely, sending an electronic prescription through a secure online system is safer than anyone being able to call a pharmacy pretending to be from the doctor’s office and order themselves a supply of Xanax or Tramadol.

I’m very glad to see that a few states now allow e-prescribing of controlled substances. The article suggests, however, that this is a widely available option and doctors are just not using it.

That is not the case. Here in New Jersey, we cannot e-prescribe these medicines. They must be handwritten or phoned in. This topic actually came up at a recent lecture given by one of the leading pain management physicians in the state. He, too, voiced his frustration that we are not permitted to e-prescribe. 

It would make our jobs easier and make these prescriptions more secure.

Hopefully, now that New York, Maine and Minnesota allow e-prescribing, other states will follow suit and fix this issue finally. 

Steven Gitler, DO

Camden, New Jersey