Monthly Archives: December 2014

Electronic medical records, for-profit medicine, and the doctor-patient relationship

emr-for-profit-medicine-doctor-patient-relationship

A complaint one often hears about electronic medical records (EMRs) is that the doctor pays more attention to the computer than the patient during an office visit. Among nations using EMR, is this a characteristically American problem?

I read an illuminating letter to the editor recently that compares the doctor/patient/EMR experience in the US and Canada. The letter was from Dr. Alan B. Astrow, a hematologist/oncologist who practices in Brooklyn, NY. He writes: (emphasis added)

Many American physicians agree that recording patient data electronically has interfered with “a deeply human, partly intuitive and empathetic process,” and has led to inefficient care. Since no one wants to revive illegible paper charts, however, the indictment encourages us to ascribe these harms to the price of progress.

A Canadian physician friend, though, says he uses an electronic record that does not disturb his rapport with patients. He also sees more patients hourly than American counterparts without compromising quality.

Why the difference? American physicians must choose from five levels of service when submitting bills. Of necessity, we tend to include extraneous information to justify higher levels and satisfy potential insurance company audits. Canada has only two levels, so doctors’ notes are short and succinct. Read more

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