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Subject:  Re: OT: Career crisis Date:  10/15/2005  7:12 PM
Author:  xraymd Number:  212589 of 312945

Greetings, rozina, thanks for your thoughts. I am indeed not computer-illiterate. But this interface really has gotten in my way. I used to be given more time per patient when I was first learning but that had its limitations because the same issues that trip me up now tripped me up then - multitudinous clicks to do something that used to be done in a flash, plus a new requirement to search for the right code which was previously done by a trained coder asynchronously from the visit (in other words, not my direct responsibility). I have been shadowed before when I was on paper and the consensus was that I was appropriately fast and thorough. I am completely willing to be shadowed again but someone would be watching me enter data into EMR offline since I can't afford either the time nor the bad will of the patients to try to clumsily do it in front of them (been there, done that and completely forgot to do major portions of the evaluation that were second nature to me without EMR data entry interference). The issues revolve around how cumbersome it is to put info into THIS system - as I've said, heaven help me if I forget to enter something in its proper sequence (the other docs are just ignoring whatever they forget because they can't afford to be held back by having to return to update it).

The nurse practitioner who joined our practice thought "no sweat" when she was asked to input onto EMR - the one she was accustomed to was a single window (no modules) not very different from a single sheet of paper as we'd all been trained to record on. She now codes on our EMR but admits to me that she hates it and that she can only do it because she burns patient slot times to get her documentation done so she can go home on time to be with her family. Those are patient visits that go missing due to satisfying documentation requirements. Management knows this and still agrees that it is worth it to them to have the bulk of the documentation on this EMR, no matter how klugy it is.

I am indeed worn out from trying to cope with this for months on end. I am depleted, working in effect 15-hour days not unlike what I did during my medical residency. The management knows this and STILL is offering me no option to offload me apart from having someone sit with me during patient appointments to judge where I am inefficient. Great - but where was that plan 12 months ago, for by now I am so tired I am not sure I have enough reserve to recover well enough to make a change that feels like yet another major hurdle in an environment where I feel like the deck is already stacked against me. That's why I've referred to bridges burned and it's a damn shame. I come home sad every day and it's been that way for months. That's a pretty sorry result, eh?

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