This is why we finally joined the AMA

[Deebs]

Since DH was in medical school (and I was in healthcare administration at the time), we have made a choice not to join the AMA. We just felt that it didn't represent all physicians and made so many decisions based on what was politically correct or popular. Instead, we joined other organizations who better represented us. That is, until the current AMA administration came ( it doesn't hurt that DH thinks very highly of Dr. Stack and that he's EM).

http://www.chicagotribune.com/busine...223-story.html

[WolfpackWife]

Oh man I would love to read it but it says I have to register for the Chicago tribune :-/


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[Deebs]

Shoot. Try to find it on Facebook - I know ACEP posted a link that works, AMA probably did too.

[gcuthbe1]

Thank you for sharing, we were debating this recently.

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[ladymoreta]

Can't read it either. :-/ But I'm interested if you have time to summarize!

[spotty_dog]

It would take a lot for us to find $400+ annual membership fees to be worthwhile. Interested to know more about what changed for you!

[Deebs]

I'm going to try to copy and paste some of my favorite parts...
"He believes doctors are overwhelmed by the demands of government regulators and insurance companies, and are losing job satisfaction and burning out"
"wants the government to allow physicians to do what they did for decades: treat patients without spending hours a day arguing with insurance companies or filling out a seemingly endless number of government forms."
" There are so many people who have intruded between the patient and the doctor. We have such excessive regulation. We are now not only told to take good care of patients, but how to provide care. We're told what tools we must use. Then we're measured by metrics that may not even be germane to what we're doing."
"There are many, but electronic health records are particularly a point of infuriation. We live in a world where a 2- or 3-year-old can pick up a smartphone and use it with no instructions. If you're not careful, they'll order from Amazon and have something delivered to your house two days later.

Beleaguered by electronic record mandates, some doctors burning out
Beleaguered by electronic record mandates, some doctors burning out
But we have graduate-educated physicians who are being forced to use software that looks like it's on an old-fashioned, DOS-based system, a Tandy, an Atari, the kind of software you can only see in a museum. And that's the software we've been given to manage patients' health and well-being. So you have physicians whose efficiency is decimated. Their ability to communicate with each other is completely crippled. And then they're told you're not doing a good job."
Then, they get into some personal questions about him and talk about the AMA's call to ban direct to consumer marketing of pharmaceuticals.

[poky]

Omg, he's totally talking about the horrible EMR system DH has to use, now. It is SO BAD.

[Deebs]

H has been dictating his charts where he is now (when he's at the outlying hospital) because their EMR is SOOO clunky. Two weeks ago, they stopped the dictation service completely. He's added at least two hours to each shift and says his charts have basically no useful information for continuity of care. Our pediatrician is actually retiring two years because of a crappy EMR.

[spotty_dog]

Cool, he sounds like a stand-up guy. But...can the AMA really do anything about the choice of EMR programs and the evolution of technology though? I mean, isn't that based on the free market, what the tech industry can provide and what the hospital can afford? (Within the guidelines of PPACA or whatever is driving the conversion for accessibility?) Color me ignorant, I know that DH's hospital recently converted to a hospital-wide system (I think previously only the ED was electronic) and it was quite an ordeal to decide what company to go with. The one they chose turned out to have fairly crummy support for the needs of the emergency department, and efficiency in the department plummeted after the switch, but after a learning curve, DH isn't complaining about it. But he's not the type to bring those types of complaints home either, so I might just not be aware.

[alotofyarn]

As someone who spends every day trying to improve EHRs, it's not that easy. You can build a fancy iPhone with all kinds of features that nobody knew they needed until they had it, and if everybody hates it, no harm done. If I build the greatest EHR, and for some reason some doctor thinks he knows better and won't use it, there are a lot of problems. I've seen the difference in what doctors say they want and what they actually want, and it's different. Doctors also don't understand the limitations of computers, which adds a challenge. Plus the amount of work that has to go into developing a new system is insane. It has to interface with all these systems and meet the very different work flow of so many different practitioners, on top of now meeting stupid governmental regulations that are meaningless.

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[Deebs]

The fed mandated EMR implementation with no thought of WHY charts were created and utilized to begin with. It wasn't for billing, it was so providers could communicate with one another and provide continuity of care. It was designed by providers. Before the government made a huge mandate with incredible financial burden, perhaps providers should have been asked to redesign a medical chart first. The whole point of his interview is that government needs to move out of the way so physicians can treat patients again.

[SoonerTexan]

I did find it on Facebook and found the EMR part interesting. I was talking about t with DH and my sister (ICU nurse) tonight. He hates whatever crap the VA used, but actually really likes Epic. My sister does too. Our pediatricians use it and bitch about it all the time...YMMV?

Her perspective was that EDs are this weird place in between inpatient and outpatient and it's hard to give them functionality that works well due to that. I wonder how much truth there is to that.

I'm pretty much with alotofyarn from the IT side...it's harder than it looks. Hell, the leading corporate equivalent (SAP) has a user interface from hell...but I get why because it is so complicated and regulated. I know some suck more than others, but I think in 10-15 years as you have more docs who started their careers in them, there will be less bitching.


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[Thirteen]

DH is not a part of the AMA, by choice. There's an explanation, but I've forgotten his reasoning.


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[SuzySunshine]

And see my DH LOVES his EMR. They are finally done transitioning to Epic - the whole hospital and his clinic is on it. He loves it - now part of that may be b/c he, his NP and his scheduler are all on the same page and they work it all very well together. He loves that he can do so much from home, etc. Maybe he's the rare case of making it work but he finds that it has saved him so much time since the transitions are done and its fully functioning.