Your Practice Won’t Be Your Father’s Private Practice

The medical practice of tomorrow will look much different than it does today. I recognize that statement to be fairly obvious, but my sense is that the transition is happening much faster than most doctors recognize right now. Only about 10% of current medical practices use an electronic medical record but the push is on for doctors to start using one. First will be the carrot approach; each doctor may supposedly receive up to $44,000 to help defray the cost of converting to a digital office. Later will come the stick: a deduction from each Medicare payment if the practice is still using the archaic pen and paper charting and prescribing methods. Private paying insurance companies are sure to follow, since it will be one more legitimized way to defer or reduce payments to doctors who don’t submit bills or document care electronically, playing the float and helping their bottom line. There may even be more penalties leveled on doctors resisting the directive to move into the 21st century. The pressure is building on doctors to change.

Most other industries are already there: financial, communications, and entertainment to name a few. Hospitals are way ahead of private practice physicians with their digital initiatives. All documentation about our patient’s hospitalization, from lab results to discharge summaries, must be printed out on paper to be included in their medical record in the office. All information sitting in the chart in the office is inaccessible to the Emergency Room doctors who see the patient presenting at night or on the weekends. We know this to be true. Traditional paper-based medical records can impede delivery of excellent medical care.

Doctors are resisting the change to EMRs, however, because there are currently just as many problems with the computer “solutions” proposed to be the panacea of all problems paper.

Patient data still needs to be input. Different medical charting systems don’t sync easily with others; a standard for data sharing between all hospitals and doctors’ offices is lacking. A private practice will need ready access to IT support, just like what’s available at most hospitals so patient care can continue when the system goes down. This change is going to require monumental energy, time, money and other resources. These are assets that most doctors have in limited supply now as they struggle to keep up with their current workload.

If the government and insurance companies and the fear of losing money can’t motivate doctors to update their practice methodology, then their patients will most likely force the change. Patients will go to doctors keeping up with the times. They will seek doctors able to communicate with them like they communicate with their family and friends, and who have systems established to help them get what they need easily, efficiently and accurately. Doctors need to know about the social web, iPhone applications, Facebook and Twitter and begin to think how these technologies will someday fit in their practice. My mother won’t be one of those patients, but I know my children will be. Read the article, “Doctor of the Future” in the May 2009 issue of Fast Company magazine for some real-life examples of medicine tomorrow happening right now, today. Whether we doctors like it or not, the future is upon us. Time to get with the program! RB