About a decade ago, a doctor friend was lamenting the increasingly frustrating conditions of clinical practice. “How did you know to get out of medicine in 1978?” he asked with a smile.

“I didn’t,” I replied. “I had no idea what was coming. I just felt I’d chosen the wrong vocation.”

I was reminded of this exchange upon receiving my med-school class’s 40th-reunion report and reading some of the entries. In general, my classmates felt fulfilled by family, friends and the considerable achievements of their professional lives. But there was an undercurrent of deep disappointment, almost demoralization, with what medical practice had become.

The complaint was not financial but vocational — an incessant interference with their work, a deep erosion of their autonomy and authority, a transformation from physician to “provider.”

As one of them wrote, “My colleagues who have already left practice all say they still love patient care, being a doctor. They just couldn’t stand everything else.” By which he meant “a never-ending attack on the profession from government, insurance companies, and lawyers . . . progressively intrusive and usually unproductive rules and regulations,” topped by an electronic health records (EHR) mandate that produces nothing more than “billing and legal documents” — and degraded medicine.

I hear this everywhere. Virtually every doctor and doctors’ group I speak to cites the same litany, with particular bitterness about the EHR mandate. As another classmate wrote, “The introduction of the electronic medical record into our office has created so much more need for documentation that I can only see about three-quarters of the patients I could before, and has prompted me to seriously consider leaving for the first time.”

You may have zero sympathy for doctors, but think about the extraordinary loss to society — and maybe to you, one day — of driving away 40 years of irreplaceable clinical experience.

And for what? The newly elected Barack Obama told the nation in 2009 that “it just won’t save billions of dollars” — $77 billion a year, promised the administration — “and thousands of jobs, it will save lives.” He then threw a cool $27 billion at going paperless by 2015.

It’s 2015 and what have we achieved? The $27 billion is gone, of course. The $77 billion in savings became a joke. Indeed, reported the Health and Human Services inspector general in 2014, “EHR technology can make it easier to commit fraud,” as in Medicare fraud, the copy-and-paste function allowing the instant filling of vast data fields, facilitating billing inflation.

That’s just the beginning of the losses. Consider the myriad small practices that, facing ruinous transition costs in equipment, software, training and time, have closed shop, gone bankrupt or been swallowed by some larger entity.

This hardly stays the long arm of the health-care police, however. As of Jan. 1, 2015, if you haven’t gone electronic, your Medicare payments will be cut, by 1 percent this year, rising to 3 percent (potentially 5 percent) in subsequent years.

Then there is the toll on doctors’ time and patient care. One study in the American Journal of Emergency Medicine found that emergency-room doctors spend 43 percent of their time entering electronic records information, 28 percent with patients. Another study found that family-practice physicians spend on average 48 minutes a day just entering clinical data.

Forget the numbers. Think just of your own doctor’s visits, of how much less listening, examining, even eye contact goes on, given the need for scrolling, clicking and box checking.

The geniuses who rammed this through undoubtedly thought they were rationalizing health care. After all, banking went electronic. Why not medicine?

Because banks deal with nothing but data. They don’t listen to your heart or examine your groin. Clicking boxes on an endless electronic form turns the patient into a data machine and cancels out the subtlety of a doctor’s unique feel and judgment.

Why did all this happen? Because liberals in a hurry refuse to trust the self-interested wisdom of individual practitioners, who were already adopting EHR on their own, but gradually, organically, as the technology became ripe and the costs tolerable. Instead, Washington picked a date out of a hat and decreed: Digital by 2015.

As with other such arbitrary arrogance, the results are not pretty. EHR is health care’s Solyndra. Many, no doubt, feasted nicely on the $27 billion, but the rest is waste: money squandered, patients neglected, good physicians demoralized.

Like my old classmates who signed up for patient care — which they still love — and now do data entry.



Credit: Original article by Opinion writer Charles Krauthammer, published in the Washington Post on May 28, 2015


About Dr. Ken

Medical Doctor, Publisher, Editor, Novelist, Playwright, Visionary Poet, Activist, Blogger
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  1. Anonymous says:


  2. Adama says:

    It’s only God that will help us!

  3. Osinachi says:

    This one na serious matter ooo

  4. Prechy says:

    What’s the way forward?

  5. Jennifer Okorie says:

    The country is frustrating everybody, not only doctors.

  6. Audu says:

    If doctors are complaining what do you expect the common man to do?

  7. Jenny says:

    It’s really sad. The situation is really terrible!

  8. Esther says:

    Why should a doctor leave? Did anybody force you to read medicine?

  9. Anon says:

    Hmmm. Serious gbege!!!

  10. Mrs. Ahmed says:

    If you truly love your profession, you shouldn’t ever think of leaving. That’s my honest opinion.

  11. Mr. Stevie says:

    I don’t blame them for wanting to leave. The entire system is messed up!

  12. Mr. Harvard says:

    Who can blame them?

  13. Mrs. Regina E. says:

    Rather than leave, why not find some additional stuff to do? Doctors have always been known to be bad entrepreneurs. You guys should start thinking of debunking that school of thought. #MyOpinion

  14. Anonymous says:

    “The increasingly frustrating conditions of clinical practice…”

    You captured it brilliantly! There’s no profession more frustrating than medicine!!!

  15. Chinyere says:

    My brother left 10 years ago. He’s a multi-billionaire now running his mega computer firm. So I can understand what doctors are going through.

  16. Anonymous says:

    We know money is not everything, but for how long shall we continue to sacrifice our entire lives in the dungeons of medicine when living conditions are abysmal?

    • Obehi says:

      Why do people respond using the name ‘anonymous’? What’s wrong with teling us your first name at least? What’s there to hide?

  17. James says:

    Medical practice has become deeply disappointing, to say the least.

  18. Mercy says:

    What is government doing to ameliorate the situation sef?

  19. Shittu says:

    Even doctors in developed economies like USA and the UK are complaining!

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