Category: Physicians

Electronic Health Records Software Often Written without Doctors’ Input

We’ve written in the past about health information technology, including a doctor’s impression of electronic medical records (EMRs) and physicians declining satisfaction with EMRs.

A recent study found out why EMRs are so frustrating for physicians: the software is often written without doctors’ input.


“Current guidelines and industry standards suggest that new EHR software should be tested by at least 15 end users with a clinical background to make sure they are usable and safe before they get federal certification.

But a new study finds that many certified products did not actually conduct this user testing, or did so without clinical testers.”

That raises another question. Can you imagine Microsoft or a hardware/software developer at Apple beta testing new products on only 15 users?  Furthermore, isn’t it beyond imagination that managers at Apple or Microsoft would ever say, “Hey, let’s not bother with testing this on 15 people, that’s just a waste of time.”


Physicians Relatively Happy with Their Careers

How happy are physicians with their careers?

In a recent survey of 1001 physicians,

• About 84% said they like being a physician.
• Nearly as many were happy with their choice of specialty.
• Yet, two-thirds said they used to enjoy being a physician much more than they do today.

More than half do not regret anything about their choice of a career path. However, one-in-five would choose a career outside of medicine if they could go back and do it all over again.

What bugs doctors?

• Four-in-ten believe there is too much interference by third-parties;
• Nearly 14% believe their ability to practice independently is slipping.
• Nearly three-quarters have no interest in becoming a patient-centered medical home.

About 10% are working in a direct-pay practice, while 43% are considering it. Yet, nearly 40% believe high deductible health plans and cost-sharing are a barrier to good health care for their patients.

Most docs are workaholics

• Only one-quarter work fewer than 40 hours per week,
• About 46% work more than 50 hours per week.
• Understandably, 70 percent don’t have as much personal time as they wish they had.

Only about half believe they have a good work/life balance. Just over half do not believe they can afford to sacrifice income to work less.

Physicians Report Declining Satisfaction with EHRs

This post is excerpted from an article, Physicians Report Declining Satisfaction with EHRs, from the American Academy of Family Physicians. The report was sent to us by Dr. Larry Pivnick, who authored a report on electronic health records.

“During the past decade, America’s physicians — particularly, family physicians — have invested lots of money and countless hours in implementing electronic health record (EHR) systems. Some physicians eagerly dived into the EHR pond; others were pushed by government initiatives, such as meaningful use, that were intended to spur technology uptake but that have become increasingly burdensome to physicians.”

[I]n 2010, 61 percent of respondents said they were “satisfied” or “very satisfied” with their EHRs, compared with just 34 percent in 2014.
Of physicians who responded to the 2014 survey,

  •  55 percent said it was difficult or very difficult to use their EHR to improve efficiency,
  •  72 percent said it was difficult or very difficult to use their EHR to decrease workload,
  •  54 percent indicated that their EHR system increased their total operating costs, and
  •  43 percent said they had not yet overcome productivity challenges associated with implementation of their EHR.

“From the physicians’ perspective, it appears that the significant investment in EHR system(s) over the past few years in the United States is failing to offer significant returns. Far from helping physicians to operate efficiently and have more time to spend with patients, the opposite appears to be the case.”

Source: Physicians Use of EHR Systems 2014

Doctors and Guns

By Lawrence N. Pivnick MD JD

Something is rotten with the state of medicine today. Well, more than one thing actually, but today’s complaint concerns the fact that your doctor has been conscripted by the federal government to spy on your gun closet. This has occurred despite the fact that as Obamacare moved its way through Congress, gun rights proponents, fearing the establishment of a federal firearm registry, acted to ensure that the program could not be used as a legal basis for mandating inquiries about gun ownership.

Medicare Accountable Care Organizations Cut Spending Two Thirds of One Percent

man-in-wheelchairThe Center for American Progress, previously a very pro-Obamacare organization, has published a study summarizing results of one of Obamacare’s most hyped tools to wring savings out of Medicare:

We first calculated overall savings by the Pioneer ACOs, finding that they reduced overall spending by 0.67 percent compared with the target amount of spending in the model’s second year.

Underwhelming, to say the least, don’t you agree?

In Forbes, Sally Pipes of the Pacific Research Institute cuts through the promotional rhetoric on ACO’s:

In the Obamacare case, the administration hand-picked the providers that could participate in the ACOs to maximize the chance of success. And even then, 13 of the original 32 organizations dropped out as a result of the program’s punishing complexity and costly regulations.

Most providers refused to join in the first place. Organizations such as the Mayo Clinic and the Cleveland Clinic — hospitals that President Obama has touted as excellent models of integrated care — declined to participate.

No wonder doctors are deeply skeptical of this model. A survey from the Physicians Foundation found that only one in ten actually think ACOs can improve quality while cutting costs.


The Physician Specialty Shortage

Many experts agree that the U.S. is about to face a serious shortage of physicians. At NCPA, we have endorsed broadening the scope of practice of nurse practitioners (NPs) and physician assistants (PAs).

However, these allied health professionals are most likely to be found working in primary practice. What can be done about the shortage of other specialists?

In an article at RealClearPolicy, NCPA Senior Fellow Thomas A. Hemphill and Gerald Knesek recommend changes to the training of allied health professionals:

PA programs vary in their length, and some don’t require a formal post-graduate specialty education. The basic PA curriculum should be standardized to two years, followed by one year for post-graduate didactic and clinical training in a certificate-awarded specialty, with the National Commission on Certification of Physician Assistants overseeing the process.

Where are the “Open Payments” from Government?

doctor-xray-2Well, now we know how much pharmaceutical companies and medical-device makers pay doctors for consulting and similar services. Paul Keckley aptly summarizes last week’s data dump from the Centers for Medicare & Medicare Services (CMS):

  • In the last five months of 2013, drug manufacturers made 4.4 million payments totaling $3.5B to 546,000 physicians and 1,360 teaching hospitals to encourage acceptance and use of their drugs/devices: $1.49B for research, $1.02B for ownership interests, $380M for speaking/consulting fees, $302M for royalties/licensing, $93M for meals, $74M for travel, and $128M for “other.”

Half of Doctors Give Obamacare D or F

Confident DoctorsThe Physicians Foundation and Merritt Hawkins (a physician recruiting firm) have just published their biennial physicians’ survey. The survey interviews over twenty thousand physicians in all fifty states and multiple specialties:

  • Only 19 percent say they have time to see more patients.
  • 44 percent plan to take steps to reduce services or find non-clinical employment.
  • Only 35 percent describe themselves as “independent practice owners,” down from 62 percent in 2008.
  • 53 percent describe themselves as hospital or medical-group employees, up from 38 percent in 2008.

Physicians’ Political Contributions Switched from Republican to Democrat in Twenty Years

One of the most interesting things about health politics and policy is that those mostly responsible for driving health costs — physicians — are the least concentrated interest group. If we want to know what the research-based pharmaceutical industry, the generic drug industry, the health insurers, the hospitals, or the medical-device makers want, we know where to go to find a fairly unified answer.

Physicians have no unified voice. The closest thing to a professional association for all physicians should be the American Medical Association, but it is not. It is a business that profits from a government-sanctioned monopoly on billing codes.

Paying Doctors for Performance Does Not Work

Aaron Caroll, in the New York Times:

doctor-xray-2“Pay for performance” is one of those slogans that seem to upset no one. To most people it’s a no-brainer that we should pay for quality and not quantity.

In Britain, a program was begun over a decade ago that would pay general practitioners up to 25 percent of their income in bonuses if they met certain benchmarks in the management of chronic diseases. The program made no difference at all in physician practice or patient outcomes, and this was with a much larger financial incentive than most programs in the United States offer.