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By Paul Goldfinger, MD, FACC. Medical Director of the Blogfinger School of Health Sciences, based in beautiful Ocean Grove, NJ.
Recently I posted a piece about how electronic medical records might compromise quality patient care:
EMR interfering with quality care
In that piece the emphasis was on how a physician, wound up entering data into a computer, might not be engaged effectively in the traditional doctor-patient interaction in the office setting, the clinic, or the hospital. We have been told that EMR’s will improve quality and lower costs, but the technology is not yet mature, and it is causing a degree of chaos in the medical setting along with huge increases in the cost of practice having to do with the turnover from traditional medical records to a new and incomplete system. It is a promise not yet kept. Obamacare, through Medicare, is pushing hard to make this happen, but it is difficult to feel confident about the administration’s current grasp of complex computer systems.
Yesterday I spoke to a physician friend who is one of the leading oncologists in the state of New Jersey. I asked him how things were going, and he said that about 125 cancer specialists in New Jersey had formed a group in order to continue the private practice of medicine and to avoid being taken over and turned into employees by corporate hospital systems. Other oncologists from other states might join the group as well, as these doctors struggle to maintain their independence.
I have heard about efforts like this, and it seems as if the old ways are dissolving and that, like Sisyphus, traditional doctors are trying to push a boulder up a hill.
But he also had something to say about EMR’s as they are currently being used. He said that they were reducing the quality of care by reducing communication between doctors. He said that collaboration between doctors has always been important for patient care, but now, he says, doctors simply type into their computers and “they don’t talk to each other any more.”
In the past, a consulting physician would often pick up the phone and discuss the situation with the referring doctor. He would also send a detailed consultation note. But now, I have a suspicion that formal opinion notes and conversations are on the decline.
Next time you see a consultant, ask your primary doctor if he has heard from the consultant and can you have a copy of the consultation report. I’m not sure how that collaboration and communication is working now, but test it out. You deserve to know.