If this country does not accelerate the conversion from paper to electronic health records, many health care reform promises will become irrelevant.
Yes. So?
American physicians are still paid on piece-work; productivity matters to them and their families. Seeing patients pays the mortgage and feeds the family.
I've successfully implemented an electronic medical record that has served more than one-half million patients since 2002, yet I know that we've accomplished this only by sacrificing physician productivity even as we've improved overall productivity in our emergency department. Optimizing an entire system often requires that components of the system operate at less than optimum in some fashion.
We can do this at my hospital because our physician staff is only partially compensated by piece-work and the alternative subsidies could be adjusted.
The NY Times got it wrong this time. Private physicians behave as they do in response to the totally distorted payment system--even the term "reimbursement" so common in this context is evidence of this distortion.
My Dad, an internist, used to say that the head-bone is connected to the foot-bone. He practiced internal medicine and gastroenterology and empirically experienced connectedness of the head-bone and the gut long before we had the science proving it.
It's not the private physicians who must be dragged out of the paper age. It's the payment system and the financing of healthcare in 21st century America.
The NY Times should castigate our policymakers, not our practitioners.
