Confessions of a Doctor: Part 1 (by Dr. Vlach)

Confession #1: I hate my electronic medical record (EMR) and would like to throw my computer out the window, at least while seeing patients.

I recently got feedback from a patient who had seen me, relayed through an acquaintance, and it went something like this: "I wasn't sure about her, because she spent our entire office visit looking at her computer, but then when I tried some of the things she suggested I started feeling better".

Win: the patient got better

Lose: the patient felt like I was more interested in my computer than in their health.

Why am I spending my visit looking at my computer rather than you? I can assure you, it is not because I want to. My happiest day in clinical practice in the past few years was when our computer network went down and I spent the morning seeing patients with a clipboard in hand, jotting down a few notes here and there, but mostly talking with patients, looking them in the eye and trying to listen and figure out how to help them get healthy. Why don't I do this every day? Physicians contracted with insurance companies are mandated to use an EMR and have a lengthy and growing list of boxes that they have to check in order to get paid. It does not matter if it is not pertinent to your health, it must be checked anyway. For example, the other day while doing acupuncture on a lovely patient, she mentioned that she is a nurse and that she thinks her very high-stress job is contributing to her low back pain. I suddenly remembered that I had recently been audited and that I was 'dinged' for not simply listing whether or not a patient was employed or not, but that I had to specify their occupation. More box checking and 'documentation', less time listening to how her stress is affecting her health. So please, if you come see me and I appear chained to my computer, know that it is not because I am not interested in you and your health. I care, a lot, and will do everything in my power to help you heal and get well. Because we are a partnership in your health, I will ask you to do some things to help you get better as well! Thanks for listening, and keep moving! Dr. V.