The third year of medical school is when a student experiences the frustrations of medicine firsthand. Once, my team admitted a transfer patient from another hospital to treat a condition that was ravaging the patient’s lungs. But before we could act, we needed to rule out a dormant infection; if our patient was unknowingly infected with tuberculosis (TB), giving our first-line therapies could lead to a disseminated infection — even ...

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Some doctors choose medicine because of the medicine, and some doctors choose medicine because of the people. I veer towards the latter: Medicine is my tool to help the person sitting across from me. However, I am finding more and more stuff getting in between me and my patients, primarily my computer. The increasing burden of gathering coded health data in the EMR, especially in light of the impending MACRA, MIPS ...

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The frontlines of health care have been transformed over the last decade as electronic medical records have been rolled out across America. Unfortunately, information technology has yet to live up to its immense promise in health care­ -- a topic that I frequently write about. As somebody who has worked with every single major EHR on my travels, I am being brutally honest when I say not a single one ...

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Last week I made a patient's chart perfect. Not bragging, but ultimately it ended up being pretty easy, and I'll explain how and why in a little bit. This was a patient I had not seen in several years, with a number of chronic medical problems, for which he had been taking less than optimal care of himself since I had seen him last. Here for a "checkup," we talked about his health ...

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Four and a half years ago I read an editorial in JAMA, the Journal of the American Medical Association, that etched a short phrase into my memory. These five words seemed so profound and poignant that I really think they almost define primary care medicine today, perhaps with the alliterative addition of the word “teach”. Dr. Abigail Zuger wrote of how the computer had changed the dynamic in the ...

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The current state of health care in America, in my opinion, has been negatively impacted by Big Pharma, health insurance corporations, health care corporations and a plethora of governmental mandates. All have placed an immense burden upon our practicing physicians who spend much of their day doing paperwork and inputting into computers rather than face time with their patients. Some find it necessary to leave the profession. Please give us ...

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I often say that electronic health records (EHRs) is like Skynet in the Terminator. I expect to turn around from my screen someday, and Arnold will lift me by my throat saying, “You haff not been doing yuh meaningful use.” We practice in a time when EHR confounds us by freezing, crashing and chaining us continuously to our work, as we spend evenings and weekends on documentation. ...

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This summer, a controversial memo written by a Google employee was leaked to the public. Within the memo, the author James Damo, details how the biology of men produces “a higher drive in status.” Google quickly condemned the statements and fired Damo, citing their pledge to standup diversity within their company. And similarly, Denise Young Smith, Apple’s vice-president of diversity and inclusion, ...

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You sign in, and there it is, your third request for your password just to open your electronic health record (EHR). “Again?” you think to yourself in frustration as your patient waits silently for you to log in and start the visit. It seems physicians are becoming increasingly frustrated with EHRs, and in most surveys, EHRs are noted as a main contributing factor to physician burnout. ...

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Medical appointments are getting shorter by the year. Sometimes it feels like doctors have no time to spend with their patients. What’s to blame for these brief clinical interactions? It could be the electronic health record, or EHR. Because of changes in how insurance companies and the government pay for medical care, doctors increasingly need to document their care on the computer, causing many physicians to spend more time with their ...

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