facades

EMR Disguises Declining Quality of American Medicine

A “Potemkin Village” is a term used to describe a façade intended to “divert attention from an embarrassing or shabby fact or condition”. This presents an impression of greater wealth and stability than reality.

Thirty years ago, physicians took short, yet accurate records by hand, often accumulating to a handful of pages over many years. Today, medical records are 4-5 pages for just one office visit. Physicians who trained thirty years ago were taught to perform an extensive history and physical exam, after which were tests ordered to confirm or exclude a diagnosis.

Today, physician offices are more often “medical mills” of Complaint, Test, Treat. The current doctor’s office visit averages 15 minutes or less. The traditional approach requires at least a half hour. It can’t be done right in 8 minutes. (The other 7 are eaten by entering information in the EMR.)

The electronic medical record (EMR) for doctors today includes all elements of traditional history and physical exam, but much is an auto-filled form with normal stats. Only the items that are abnormal are the parts the doctor changes. Physicians are required by Medicare to produce extensive notes via EMR in order to get paid.

In the last 8 years, the bureaucratic red tape, regulations, and mandates have driven up the cost of private practice overhead so much that half of those in private practice left to become employees of larger groups. For many, it is impossible to make a living with an independent practice dealing with all the government requirements. Being an employee does not remove the issue of EMR, but spreads the costs over a larger company system. The medical system has damaged the quality of American medical care, destroying the patient-physician relationship in place of the high-tech EMR Potemkin Village.

Gerard Gianoli, MD, FACS specializes in Neuro-otology and Skull Base Surgery in Covington, LA. Dr. Gianoli opted out of Medicare in 2001 and has had a 100% third-party-free practice since 2005. His private practice has a worldwide reach, with patient referrals coming from all over the United States and from around the world.

http://www.aapsonline.org/index.php/site/article/electronic_medical_records_the_potemkin_village_of_healthcare/
Gianoli MD, Gerard. “Electronic Medical Records: The Potemkin Village of Healthcare.” What’s New. Association of American Physicians and Surgeons, 29 Feb 2016. Web. 1 Mar 2016.

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