From the
President
BRUCE A. SCOTT, MD
GLMS President | [email protected]
IN CLOSING
O
ver the last 12 months, I have had
the opportunity to share my thoughts
with my friends and colleagues
through our President’s e-Voice. I tried to
give you a feel of who I am, what motivates
me and express my views on issues facing our
profession. In exchange, I have heard from
many of you, motivated at least a few to action
and obviously “struck a nerve” on a couple of
issues. I must be fairly centric because most
of your comments, at least those shared with
me, were supportive. Physicians are clearly
most exercised by administrative hassles that
take us away from patient care.
Not surprising, the article on electronic
medical records aroused the most response.
There seems to be a general belief that the
move to computers has taken our focus off
of the patients. In other industries, computers
simplify the workflow, facilitate the user and
improve accuracy. In medicine, the EHR as
implemented has reduced efficiency, frustrated
physicians and I believe actually increased
the risk of error (overuse of templates and
cloning, numbing effect of repeated pop up
warnings, and generally distracting physicians
from patient care). A computer should reduce
the repetitive nature of tedious tasks, yet I find
myself clicking here, clicking there, opening
this, double clicking here, and selecting this…
repeatedly. It seems each computer system has
its unique series of clicks, double clicks and
logistics. I wonder what the administrators
would say if we demanded that they take multiple evenings or a Saturday or a day without
pay to learn a new computer system that was
going to reduce their productivity and become
a major source of frustration for them. The
answer is not to abandon computerization, but
to involve actual practicing physicians with
IT experts to find solutions and then share
those solutions across medicine. Yet, the EHR
vendors seem content to let each medical staff
“reinvent their own wheel.” Unfortunately, it
seems this has just become another problem
for physicians to complain about in the doctors’ lounge.
My recent article on the changing modes
of practice and move towards employment
generated a number of probing questions and
heartfelt comments. One physician wondered
why she would be prosecuted if she were to pay
a primary care physician for referrals, while
hospitals can direct referrals without penalty.
Another asked why he has to disclose to every
patient in writing his ownership in a CT scanner but employed physicians routinely refer
patients for imaging to centers owned by the
same hospital, where the charges are typically
higher, without similar disclosure. Perhaps
most concerning, a psychiatrist thanked me
for bringing to light a topic that he says is “an
invisible epidemic of stress and depression
among our colleagues.”
Reaching “hardened targets” is always a
challenge and some members are about as
“hardened” as you can get. After my articles
on the value of a national organization to
represent physicians and the paucity of PAC
contributions from physicians, I heard from
a number of members who were motivated to
contribute to the KY Physicians PAC, to get
involved in political advocacy or to join the
AMA after resigning their membership many
years ago. The recent success of the AMA
working with other medical and specialty
societies to achieve repeal of the Sustainable
Growth Rate (SGR) certainly puts enough
money into every physician’s pocket to pay the
dues for many years to come. This fix not only
means that physicians will avoid the pending
21 percent cut in Medicare payment but more
importantly it removes the albatross of the
uncertainty of a cut each year from around
the neck of all physicians. No association is
perfect, but our profession needs a strong local, state and national voice.
By increasing our involvement with local
legislators and the business community, we
successfully moved issues from the pens of
our KMA Delegation to the floor of the KY
State Legislature. GLMS members connected with legislators, testified before legislative
committees and got the attention of health
plans with our actions. Legislation on heroin
including “Good Samaritan” language and
end of life decision making which we had
supported became law. I am confident “Fair
Contracting” legislation will pass in 2016 and
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