Physicians Can’t Seem to Live with and Can’t Live without Electronic Health Records

Mark Friedberg
Mark Friedberg

Physicians can’t seem to live with and can’t live without electronic health records. Or so says a new RAND survey.

The recent survey, conducted by the think tank the American Medical Association, found that most doctors strive to provide the best care possible to patients, but that the biggest obstacles for doing so is electronic health records, according to a report published by Health Tech Zone.

But, even with this hindrance, and though they consider the technology intrusive, 80 percent of respondents said they would never go back to paper patient records. The take away from the study is that physicians just want the EHRs to be “less cumbersome and time-consuming to use.”

“Physicians are pleased and happy professionally when they perceive that they’re giving high-quality patient care, and they’re unhappy when they can’t meet patients’ needs and when there are barriers to quality patient care,” said the study’s author, Dr. Mark Friedberg, a scientist with RAND and a practicing general internist in Boston.

“The findings on [electronic health records] were a real surprise to us,” Friedberg said. “They had a very important and powerful effect on physician satisfaction.”

According to Health Tech Zone, the overriding conclusion of the study is that physicians want to provide the best care possible to their patients, and when they are prevented from doing so, they report dissatisfaction with their jobs.

“Medicine isn’t a job. It’s not even just a career. Medicine is a calling,” AMA president Dr. Ardis Dee Hoven said. “But the bureaucracy can take a toll on even the most dedicated physicians. Over time, the obstacles to providing patients with high-quality care can diminish physician satisfaction.”

The study was published by RAND Corporation on October 9 and included responses from doctors from 30 physician practices of various sizes in six states. Researchers interviewed a total of 108 physicians and 112 practice leaders or clinical staff from these practices. The researchers also sent surveys to about 450 doctors in these practices.

Doctors were happier when they had more autonomy and greater control over the pace of their work, Health Day reports. Physicians in physician-owned practices or partnerships also were more likely to report satisfaction compared to those in hospital or corporate-owned practices. When the pace of work or excessive administrative work led to limited time with patients, doctors were more likely to be dissatisfied, the survey found.

One surveyed doctor said he felt he was shortchanging patients by seeing more people throughout the day. “I guess it’s the wave of the future to be able to see more patients in a shorter amount of time,” the primary care physician said. “I just don’t think a 15-minute visit is remotely feasible.”

Most doctors approve of electronic health records in concept, but right now they require physicians to input a significant amount of data, and most of that data needs to be entered in template form, which doesn’t leave them much freedom to add personal notes. Entering this data often interferes with patient time, Friedberg said.

Also, the systems are not interoperable so there’s not necessarily a seamless transition of records from one doctor to another or from a hospital to a doctor.

The implementation of electronic health records has also been more expensive than many initially expected, according to the study.

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