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    Sunday, February 13, 2005

    EMR Stress Syndrome: It's been just over two weeks and 320 patients since my office went electronic and the stress is still showing. Little things that normally wouldn't matter are being conflated into major disagreements among the staff. I'm doing more of the patient call-backs and prescription refills than I usually do to take some of the stress off of them and to keep us from falling behind in our paperwork. The most computer-averse among them threatened to quit late Friday afternoon, but changed her mind by the time I had time to accept her resignation. (Or so my office manager tells me.) I have to admit, some of this is my fault. I myself feel on-edge and uptight and I'm sure the staff picks up on it, despite my best efforts to hide it. Not that I criticize or harangue them, but I'm sure I come across as more abrupt than usual.

    Truthfully, it's been a rough week, and not just because of the adjustment to the computerized records. Influenza and a viral gastroenteritis are going through our area, which means we're busier than usual. I probably should have done the implementation during the early summer when we're not as busy because people are away on vacation. (But that's when the staff goes off on vacation, too.) And then, we were down one person ourselves because of illness. In fact, I spent my afternoon off seeing patients by myself, with no staff, because we couldn't fit them in the morning schedule when there was just myself and the medical assistant working. That put to rest any thoughts I had that I could run an office truly solo, with no staff, as some doctors are doing. To do that successfully, the practice has to be fairly small - small enough to allow patient visits every 20-30 minutes rather than every 15 minutes. I would have to drop about half of my patients to accomodate that kind of schedule. And my revenue would drop by half, too. Paying my staff doesn't take 50% of my revenue, it takes about 30%. I would end up making less and working harder without them.

    But, as tough as it's been these past two weeks, and as tough as I expect it to be over the next 4-6 months as we continue to convert patients over to the new system, I'm still glad I've made the leap to computerized records. My paper charts were out-growing their storage space and I really had no other choice, unless I want to comb through the charts periodically looking for people who haven't seen me in three years and then pay to have them stored elsewhere. And pay again to retrieve the chart when those patients come in for a cold or earache, as they often do. (They're usually the young and healthy who rarely have the need to see a doctor). It will be much easier for me when I reach retirement age, or if my malpractice insurance becomes unaffordable and I'm forced to close, to have my records on a computer rather than in yards and yards of chart racks. When I moved from my employed position to my current solo practice a year and a half ago, those charts were packed into 50 file boxes that took up about 180 square feet of room. The local medical society charges $12/box per month to store them safely. And they grow with each passing day as more information is added. Being able to store them in a compact, digital form is, alone worth the investment.

    posted by sydney on 2/13/2005 10:41:00 AM 0 comments


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