October 17th, 2011

My Doctor Is a Technophobe

I’m a patient, not a doctor. In the past two years, I’ve seen two different primary care physicians and three specialists. The details of my case would probably bore an audience of cardiologists (peroneal nerve damage and related orthopedic problems), so I’ll skip those. What’s more interesting — and surprising to me — is what I witnessed when each of these 5 physicians interacted with my electronic medical records.

I live in the Boston area — hardly a healthcare backwater. So most of my lab tests and imaging were available to my doctors right on their office computers. But all five had a great deal of trouble accessing what they needed.

One of the primary care docs couldn’t manage to navigate the system after he logged in and gave up right there in front of me. The other PCP (filling in for the first) was so slow using the system that, at a moment when I sensed it wouldn’t be embarrassing, I reached over the desk to point at her monitor and show her how to get what she wanted. “I need a little more practice at this,” she admitted. We both laughed and moved on.

The specialists had to download MRI images. Not one of them managed to access all the desired scans on the first try. One called in a front-office worker to help her. Another said to me, “We’ll make do with the ones we can see here.”

The last specialist was the most intriguing. After he tried unsuccessfully to locate the desired images, I offered to help, and we quickly found what he was looking for. Then, in a moment of candor, he confessed to me that he usually reviews scans in private because he’s “bad with computers” and it takes him a while to “work the thing” (his words). Then he said, “I may be an MD, but I’m a technophobe.” Yes, he used that term.

“That’s okay,” I said. “I’ve got my own phobias.” Again, we laughed and moved on.

All 5 of these doctors are competent professionals. I never questioned the quality of their care. But their discomfort with technology took me by surprise, especially given that the oldest of the five is in what I would guess to be his late fifties, the youngest barely 40 — certainly not old fogeys.

Now I suppose it could be that cardiologists are a notch above PCPs, neurologists, and orthopedists. You technology whizzes may be scoffing at these amateurs. And, of course, these records systems should be more user-friendly. But the consistency of my physicians’ awkwardness with systems that I (no technology whiz) was able to help them navigate does make me wonder how pervasive technophobia is among MDs.

Are there substantial percentages of physicians who are hiding their lack of computer skills out of shame? Or did I, by chance, find myself encountering some of the few who fit this technophobe profile? Are you personally as comfortable with technology as you’d like to be? What do you do when technology stumps you on the job?

2 Responses to “My Doctor Is a Technophobe”

  1. Tina Dobsevage, MD says:

    No conflicts of interest

    Competing interests pertaining specifically to this post, comment, or both:
    I do not view myself as a technophobe. However, the system I use in my office though CCHIT and Drummond certified, still is not configured to order labs or receive results directly from and to the EHR though it will be in the future. The process of getting Enzo and quest to interface with my EHR requires cooperation between multiple parties who seem to find it difficult to get together. I have online access to the hospital intranet where I can view most results. I have online access to two or three other radiology offices. And I have online access to three of the four labs I send specimens to. Each one has a different log on and password. It is all enormously time consuming to use, i.e. accessing all results in this way easily doubles the time of an office visit.

  2. Forcing evolution does not work.

    I have had an EMR for 7 years. It is functional but not great. It was better than paper until it needed to change to become compliant with Federal standards for “meaningful use”.

    It now takes me 4 to 5 times as long to write a prescription providing the e-script third party service is up and running, which was not the case yesterday mid-day. In addition, the other changes mandated by “meaningful use” criteria result in many many mouse clicks and screen changes that were not needed before. The result is I lose meaningful time with the patients.

    Another Internist in town initiated an EMR this Fall. Her office used to average 23 to 25 patient visits per provider per day. Post EMR, the time needed to comply with “meaningful use” results in a reduction of productivity to 18 patient visits per provider per day. There is no way to sustain a practice when the EMR reduces productivity by 25%!

    I realize that some genius somewhere, who is not involved in clinical medicine, determined that an EMR such as this would improve efficiency by reducing redundant testing. It would also allow better reporting which could lead to improving quality and reduced cost of medicine. One small problem is that if we decrease primary care productivity by 25%, the few primary care physicians still in practice will be eliminated.

    Hospitals will own all primary care, which arguably is one of the unstated goals of the current direction of CMS. We did a study of health care costs in our community a few years ago. It turns out that hospital owned practices are twice as expensive on a PMPM basis than independent primary care. This observation has also been validated by at least one insurance carrier who has shared their statistics with me. Therefore in an attempt to control costs, we are decreasing efficiency and driving providers into the most costly structure for health care delivery.

    I am in favor of an EMR, indeed I purchased one for my practice long before it was required or rewarded. Unfortunately, all the add-on junk mandated by the Feds, which add no value to clinical medicine, will ultimately render this project meaningless when it comes to improving care delivery and reducing costs.

    Technophobe or technophile, it does not matter. The current generation of “meaningful use” EMR will result in significant negative unintended consequences.

    Competing interests pertaining specifically to this post, comment, or both: