Thread by @kurteichenwald

1. Folks should know more about how terrible electronic medical records are. This is another issue: How for-profit entities undermine health care through electronic medical records. This story was related by an MD friend, as well as a number of his partners.....

2...the old-time "one person running a clinical practice" is largely dead. They are now owned by corporations or large institutional groups. As reimbursement is cut back by insurers trying to max profits, doctors are told by their owners to see people faster and faster. This is..

3...why you are unable to see your physician for much time. They are literally on the clock. If they fail to see a patient every 10-15 minutes, they get dinged. Meanwhile, the corporate/institutional owners are looking for everything they can to increase reimbursement....

4...enter the electronic medical records. Companies have pored through reimbursement rules and come up with required questions that have nothing to do with health care, and everything to do with making money. So, a doctor is required to fill out certain things on electronic...

5...records every single time, for example, spending a moment telling patients about the dangers of smoking in appointment after appointment with the same person. The number of useless questions takes up several minutes. The reason why electronic records make this happen...

6...is because just touching the screen (yes/no) feeds into the billing data and results in reimbursement. But if you have 5 minutes of nonsense, and a 12 minute limit on time you can see a patient, that means MD has 7 minutes to deal with the actual health problem....

7....this is impossible to do. Everyone knows it is impossible to do. The companies that own the medical practices know it is impossible to do. So, how is it handled? The MDs either commit fraud or lose their jobs. They enter "discussed smoking" etc when they didn't. Which....

8...means your medical records are not correct. And everyone knows your medical records are not correct.

Result? Internists - the ones hit by this the most - are dropping out. They are opening concierge practices, joining drug companies, on-site corporate employee health....

9...I used to know scores of internists with practices serving insured patients. Now, all of them are gone. They did not want to commit fraud. They did not want to provide crummy medical care. They did not want to be under the gun all the time. And they did not want to create...

10...medical records that undermined patient health.

America is terrible at planning for the future. Present-day profit is all we pay attention to. We are losing internists, which means that the pressure on the ones who stay will go up and up. Which means they will leave....

11....at some point, if something is not done, we will lose our general medicine doctors. All in the name of more more, more patients, more money, more reimbursement, more insurance profits. This must end.