Physicians

PHYSICIANS/TECH: The intransigence of the AMA knows no bounds

Here’s what I wrote for FierceHealthcare today.

Attendees at the 22nd annual TEPR meeting could be forgiven for being a little anxious about the future. Conference organizer and Medical Records Institute Peter Waegemann put out a call for action, noting that at the first conference some speakers thought electronic medical records would be here within three years, then ten, and now more than twenty years later we’re still arguing about different standards. The keynote from AMA secretary Joseph Heyman showed where the problems lie. Although Heyman is a solo practitioner who runs a paperless office and has been using EMRs since 2001, he trumpeted his organization’s party line—No cuts in Medicare, or risk that doctors will stop taking patients. Great suspicion of pay for performance. Opposition to mandates to use technology. Demands for straight payment to acquire and use technology. Apparently the medical world has gone to hell and it’s anyone but the AMA’s fault, so apparently we shouldn’t expect doctors to save the health care system by using IT, unless it comes at no cost and inconvenince to them.

I’ll be back with a little more, and some much harsher words later.

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Barry CarolJoe HeymanTom LeithPeterjack daniels Recent comment authors
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Tom Leith
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Tom Leith

Quick reaction: We docs know how to use computers. Thanks for building them. I’m using computers, but you can’t expect anyone else to be the best, highest quality, most efficient doctor they can be unless you give them more money. The only thing non-docs should care about is the disgraceful way they don’t pay docs for taking care of the poor. So long as one person is not entitled to pay a doc, Health IT is worthless. There are no medical experts at insurance companies, but they are in the driver’s seat, abusing information technology, and changing the medical services… Read more »

Barry Carol
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Barry Carol

Reaction to speech by Joe Heyman: While I thought the speech was very interesting, I got the impression that the AMA and doctors generally think the solo or small group practice is somehow sacrosanct, and trends like IT should be both tailored to that model and heavily subsidized. However, the economic world in general became considerably more capital intensive and, especially, IT intensive over the last 20 years or so with the trend continuing apace. The ability to afford these new tools, including everything from EMR systems to multi-million dollar MRI machines requires larger economic entities. Why aren’t doctors all… Read more »

Joe Heyman
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Joe Heyman

Ladies and Gentlemen: I am including my complete speech below so that you can decide for yourself if my speech was so terrible, or if the mood of your lead blogger might have been the problem. He was clearly on the attack and quite unpleasant. He was more interested in making a point than exchanging ideas. My entire speech is below, and I hope it all gets placed on this blog: Thanks so much for having me here today. It is a privilege to represent the 900 thousand physicians and surgeons of America. And to discuss the physician perspective as… Read more »

Eric Novack
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Tom- I have to respectfully disagree with your statement
“docs and hospital departments and hospitals don’t care about interoperability because they don’t really want to interoperate”
Doctors would love to have interoperability as it would make choices for IT easier. It would make it much less likely that they will end of with the “sony betamax” of EMR and practice management software.

Tom Leith
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Tom Leith

Jack Daniels asks: > isnt IT supposed to make things EASIER for docs? > Why would they protest against it? This depends on whom you ask. There are all sorts of claims from vendors about benefits to clinicians, and most of them are true. But there are costs (besides time and money) as well. IT is certainly supposed to make things better for patients. Its side-effects are a mixed bag for clinicians of all kinds. However, to carry a physician-centric view of the world forward into the Promised Land of Information at Your Fingertips&reg would be what’s called a Local… Read more »

Peter
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Peter

I’m not sure if Matt placed this discussion and the previous one so close on purpose; “TEPR Conference, Phil Sissions, who recently left working for the UK’s NHS’ National Program for Information Technology – GPs have revolted when being told that they had to change out their practice management systems” Introduction of IT on both sides of the pond has the same problems. Docs have to put up with what the rest of us have to do all the time – throw out that old technology for some newer faster, better system. I’m certainly suspect about going out too fast… Read more »

ERic Novack
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JD- ‘VISTA’ is the VA system. Approx 1 year ago the plan was to make it available free, the next day it was changed to a small fee (but of course that does not account for the IT support costs…), and by the next week, the idea was shelved… VISTA has ‘down’ scalable issues that, to my knowledge have not yet been worked out. Also, it was not designed with a ‘back end’ in mind for scheduling and billing integration. Also, it is not really designed for the outpatient setting. And it is not optimized for specialty practices. I do… Read more »

jack daniels
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jack daniels

BTW, this is not my doman so forgive my ignorance… but isnt IT supposed to make things EASIER for docs? Why would they protest against it? You give them a standardized electronic system that works in all hospitals, all clinics, and serves as a central repository for all prescriptions, lab tests, patient charts and I think the vast majority of docs would be happy with that. but my current impression that that there is no consensus. We have 1000 different vendors competing, wtih no standardization framework in place. Until that gets sorted out, its premature to blame doctors for failing… Read more »

jack daniels
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jack daniels

Good grief guys please get a clue as to what the AMA really is.
They are a TRADE ORGANIZATION, NOTHING MORE. They dont dictate health policy. The AMA is not nearly as powerful as the NEA in the teaching profession, with its organization of massive unions.
Less than 40% of all doctors are members of the AMA. They do NOT speak for all doctors.
Lets quit putting the AMA up as some kind of monolithic doctors union. Thats simply pure fantasy.

eric Novack
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When you expand… please tell us all how doctors in general and the AMA in particular is responsible for the lack of interoperability and lack of standards for electronic medical records for the last 20 years… It is honest to question the impact of the planned 30% (not incuding inflation, in which case it is closer to 50%) cuts in physician reimbursement over the next 6 years. (Remember that the hospitals get planned increases of likely about 3% since the funding scheme is different.) It is honest to question P4P as planned… Will they use the model of, for example,… Read more »

Matt S.
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Matt S.

Put simply, I think the AMA is essentially one of the most self-entitled and backwards labor unions in this country, if not the world.