EHRs: The Road to Serfdom?

Big BrotherWhile I’ve been skeptical about the cost-effectiveness and readiness of EMR/EHR technology, Dr. R. Wayne Porter or Terrell, Texas sees something more sinister:

The Electronic Health Record is a Trojan Horse which will open the gates to an invading army of bureaucrats and central planners and give them the tools with which to enslave us. Using it they will track every physician’s practice and compare it to their mandates (which is what “guidelines” will become). Dissidents will be punished. Those who fail to conform will be dropped from insurance company and medicare panels and/or have their licenses revoked. We must reject this poisonous “gift” and resist every effort to implement such a system, not only for ourselves, but for the sake of our patients, the citizens of this Country, who will be ensnared as well.

Why do we lie meekly still as, one by one, the threads of third party and State control are fastened over us? They are not yet so numerous that we cannot break free of them. Do we fear the loss of our comfortable lifestyles or our position and prestige (whatever may be left of it)? We have only to stand up and cry “Enough!” and they will be forced to scatter like cockroaches in the glare of the light.

That’s a pretty strong indictment.  I think EMR/EHR technology will produce cost savings, fewer errors, and better patient care…some day.  The technology is not ready.  But when it is ready, physicians should embrace it more than fear it.

As for third party and State control, are there large numbers of American patients who are burning their Medicare and private insurance cards out of frustration with third party-payors denying treatment and overriding physician decision-making?  This would seem to be a far greater source of both patient and physician dissatisfaction with the third party-payor system than whether one’s office notes are on sheets of paper or in a hard drive.  Everyone seems to hate health insurance companies, but is that hatred taking the form of large numbers of patients telling them that they will no longer pay their premiums?  We may one day see such a backlash, but not anytime soon.  For now, patients by and large seem to find it equitable or at least tolerable to pay enormous monthly insurance premiums to health insurance companies that will often deny coverage and stick them with the bill.  It is the unwillingness of the vast majority of patients to pay for their own health care that empowers both the state and private third party-payors.

If physicians stand up and cry “Enough!” will they will be forced to scatter like cockroaches in the glare of the light?  Since only 4% of American physicians currently use fully operation electronic records systems, it sounds like physicians have already cried “Enough!” yet the cockroaches seem undisturbed.

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