Electronic Health Records Harms the Doctor-Patient Relationship
By Lawrence N. Pivnick MD JD
A Texas Medical Liability Trust poll found that most of the patients interviewed said they wanted a physician who made them comfortable, to whom they could talk, one who actually listened to them. And they valued those attributes in their physician even more highly than his clinical acumen.
What about that cherished doctor/patient relationship which everyone seems to value so highly? Have you ever been “examined” by a doctor who uses EHRs? If so, you would have noticed him or her madly typing away on a computer keyboard, or checking off boxes on a template of every possible historical and physical finding imaginable, and ignoring the patient almost entirely. This is done partly to prevent medical malpractice lawsuits, because if something has inadvertently been omitted from the record, the doctor may be open to a negligence claim. But also, more documentation allows for higher coding of the visit and therefore greater reimbursement.
More is better, right? Not if the extra documentation is nothing but regurgitated gibberish brought forward from previous visits. In the old days, my office notes for most patient encounters were four or five lines in length, chock full of valuable, illuminating information. Nowadays, my notes for each visit are a full page long, at least, bursting with extraneous nonsense to cover myself and to justify my charges. And EHRs only exacerbate the problem. Rather than improving doctor/doctor communication concerning a patient, it is now more confusing than ever, as we wade through mountains of irrelevant junk in the electronic record.
Excerpted from Lawrence N. Pivnick, “Electronic Health Records: A Physician’s View,” National Center for PolicyAnalysis, Issue Brief 170, August 2015.
Lawrence N. Pivnick MD JD is a contributing fellow with the National Center for Policy Analysis
During my last three doctor visits, my doctors gave me their full attention. It would have made me feel like I was being ignored if I had to compete for their attention with a computer screen.
I’ve heard patients say how disconcerting it is for their doctor to be furiously pecking away on a keyboard while they’re trying to explain their symptoms. I’ve also heard physicians talk about how frustrating it is to be hunting for the appropriate pull down menu or the right words to type while seeing a patient. It’s a productivity buster.