1) Hospital administrators failed to anticipate the backlash doctors had for EHRs.
My take: Physicians will revolt against anything that takes more time or slows patient visits.
With health IT, there is rarely physician input. This is not purely the administrators’ fault, since they are not expected to know the details of physician workflow.
To ensure compliance, two things need to be guaranteed.
First, documentation and patient flow have to be made easier and faster by electronic records. Next, it has to work as close to 100 percent of the time as possible. Minimal crashes, bugs and disruption.
If these basic conditions can’t be met, physicians will opt for the status quo.
2) The number of doctors with MBAs are rising.
My take: Bravo. A business degree or background should be mandatory prior to medical school.
It doesn’t have to be a Masters-level degree. However with practices essentially functioning as small businesses, doctors are going to get killed without adequate business training.
3) A renowned Boston pediatrician is accused of sexual abuse.
My take: I don’t know anything about the case and cannot speculate as to whether the charges are true or not.
Serious allegations like these can destroy a physician’s reputation and practice. A career without a prior patient complaint and a rise to national prominence will be forever tainted by these charges.
If they are not substantiated, I would like to see the media report that with equal enthusiasm.
Related posts:
- Doctors with MBAs
- Why would a doctor stop seeing patients?
- Physicians versus administrators
- Middle Eastern physicians
- The low adoption rate of electronic records
- Recruiting versus retaining doctors
- A Medicaid-majority patient panel
{ 11 comments }
The issue of involving those who will use an electronic system in it’s development, particularly with regard to workflow and user interfaces is not unique to Health Care.
The generic issue is that those who know the work flow best and are articulate/intelligent enough to communicate it clearly to system designers are also those who are too valuable to be sidelined into such a project.
The usual compromise is to put something up and then spend a year(s) taking inputs and reconfiguring it. It isn’t less expensive, in fact that’s often a more costly way of doing it, but it can be done without actually pulling the best off their work for extended periods of time to meet and work with designers.
On the issue of EHR, don’t feel alone in the woods. Lawyers are expertiencing the same thing, but those makig the decisions are ALL government employed bureaucrats. Of course, they know more. Our state’s award winning system was designed to be used to keep enrollment records at colleges not be a court system database.
“Documentation and patient flow have to be made easier and faster by electronic records.” I completely agree. The problem is that the premise of current EHRs is one of “enter your data into me. Its technology, so it must be better.” While its clear that information technology has not been applied to the health industry, i think it is also clear that there has been no innovation related to their application. I think part of that has to do with technology workers who do not understand the intricacies of the health care system. But its with articles like those on your blog that we can hopefully better understand health care and its complexity in America.
-Avi
“My take: I don’t know anything about the case and cannot speculate as to whether the charges are true or not.”
Kevin, you’ve been able to diagnose malpractice, or the lack thereof, with less info than this. Why so reticent now?
Tell me, do “patients lose” if this doc is convicted?
I’m sorry, but this boston doctor is guilty as sin. 8 different complaints by different people. Not only that, but he’s had at least 2 complaints stretching all the way back to 1988.
One complaint could be bogus. But this is a trend, and trends like this are rarely bogus.
Pediatricians across the USA do genital exams on a daily basis, and almost none of htem get accused of sexual assault. The fact that this guy has been accused at least 10 separate times over the years is appalling, and I’d bet money that the complaints are legit.
May well be, we’ll see.
Here’s a story of a doctor who was falsely accused of sexually molesting a patient:
http://opinionjournal.com/extra/?id=90000445
Require docs to get MBA? Given what the MBA’s did to my former clinic (some of them MD’s), I think I would take myself to another country when I got sick.
Anyway, isn’t their carrying the “there ought to be a mandate” ethic to the extreme? Every action has unintended consequences, and since B-school students perform worse than prison convicts on ethical reasoning exams (I didn’t make this up!), the unintended consequences of forcing physicians to acculturate to that professions ethos first would be catastrophic.
EHR will work just fine if they are allowed to evolve when, where, and as they are found to increase efficiency in healthcare just as in other sectors of the economy rather than mandated by centralized authority.
Hi Kevin,
as others commented, HealthCare is not the exception to the IT headaches and ‘growing-pains’. I’m just surprised to see the same mistakes being made that were made in other professional areas (I’m specifically thinking of finance). Less ambitious systems that can grow on their own accord, ie, by what doctors and administers demand, is in my opinion the only way to go. Large complex systems that are let loose in one fell swoop are the devil. As I said, in my *humble* opinion
Adam
While I appreciate the appropriate restraint on speculation of guilt or innocence of Levine, you seem to imply by this line “A career without a prior patient complaint” applies to Levine and not just some general situation.
Levine does not himself have a career “without a prior patient complaint”. In fact there have been multiple formally lodged complaints against him of similar nature.
If I speculated, the press attention is not only related to the prominence of the physician and shocking nature of the complaintm, but that it is NOT merely one isolated ‘recovered memory” complaint.
Re Mel Levine:
I am not a physician, I’m an educational therapist. I’ve studied Levine’s approach to LDs and use some of his materials in my practice.
SarahW wrote: In fact there have been multiple formally lodged complaints against him of similar nature.
To be precise, according to the Boston Globe, there were exactly two: one, a lawsuit, in 1988, alleging improper touching of the testicles. It was dismissed. Two, a complaint to the medical board in 1993, alleging that Levine asked improper questions and touched the complainant’s penis. That complaint was also dismissed.
Pediatricians should be touching their patients’ penises and testicles as part of examinations. For my part, I would want to know how many pediatricians have complaints of “improper touching” lodged against them, before jumping to conclusions about the nature of the charges against Levine.
The twenty-three year gap between the alleged incidents and the lawsuit strongly suggests some form of recovered/repressed memory therapy.
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