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Subject:  Re: OT: Career crisis Date:  10/15/2005  3:45 PM
Author:  xraymd Number:  212574 of 308782

Greetings, Booa, thanks for your thoughts. The reason given that the practice will not entertain having a coder translate my paper documentation to EMR capture is that "we have made a commitment to be a 100% EMR practice." So the implication is that if I am not keeping up, then I am falling below their standard of capture. I've been effectively told to streamline and to get simultaneous - but there has not been any alternative given to what happens if I don't (or can't). I am now a liability to the practice because by not adapting, it makes extra work for others that they had not planned on in their business plan. Again, the fact that my patients are very happy means less than that I am an outlier. And it really is pretty dreary not being listened to nor respected when I have said repeatedly that they will indeed get the old productivity from me if they back off and allow me to do what I've been able to do demostrably before. That appears to be worth less than being able to continue to say that we are "100% EMR." (Okay, that sounded bitter and I am trying not to become that way, but it is not easy.)

Looking for another job is going to have to happen. It's hard for now since I am working literally from 6am (when I take the signout from the on-call doc the night before) to when I leave the house between 8-8:30am to round at one to three hospitals (depending on where we have patients) to returning to the office by 2pm (earlier if I can get there earlier) to see patients in the afternoon till 5pm, then spending until generally 9pm signing off on labs/reports and documenting. Not much chance to job hunt. I will say, though, that I COULD devote my half-day off per week to doing this and it is apparent that I sure better start.

This EMR crisis is not unique to me. Plenty of other practices are in "adapt-or-die" mode and there are many ways in which this could be handled - not every practice demands electronic coding in front of a patient. Ironically, I have thought that it would not be such a bad idea to draw upon my prior experience as a graphics-based programmer in pharmaceutical research to switch jobs and turn some attention to ease-of-use principles in user interfaces for this purpose. How well I understand some of the bog-downs! But that sort of job opportunity is not available locally and maybe amounts to wishful thinking. For me to meet the practice's nut, I need to see between 10-14 patients daily after my hospital mornings (certainly there is revenue in seeing hospital patients but that is just one side of the coin) and I have not come anywhere near this target since being forced onto EMR since March of this year. I have not wanted to admit defeat but I am getting ever readier to, given the bad blood this has engendered. I miss having fun at work and laughing with everyone and checking in with the other docs - that's all vanished since it has felt so grim. Only with the patients is that good mood still prevailing (I don't share my frustrations with them at all about this). Sigh.

Thanks, everyone, so far, for your great support. I can't tell you how much it means to me.

xraymd
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