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Subject:  Re: OT: Career crisis Date:  10/16/2005  6:34 PM
Author:  xraymd Number:  212664 of 312945

Greetings, PineLevel, the EMR that the practice uses is tied into the patient database of the practice. If there were an alternative interface to collecting the information and transferring it to the patient database, it would theoretically be okay IF

1) there were seamless support to linking up outside software to the patient database and other ancillary databases (lab module, coding module, etc)

2) it did not violate the constraints of HIPAA (the new regulations regarding patient privacy rights and restrictions on how their information can be coded, stored and distributed)

There are a boatload of choices and I am totally persuaded that there will be newer and better options all the time (this is a moving target). JustSilly nailed it when she said that the EMR I am presently on is the software our practice has committed to. I don't see any departure from it anytime soon.

Of note, I just had a phone conversation with our office manager this afternoon, away from the office. She understands fully that we are at an impasse and she recognizes fully that I am completely burned out. She is not in charge of making decisions on behalf of the practice what they will or will not support in the way of offloading me by having someone input my paper documentation and freeing me from doing it. But she definitely understands that we are at that point, and it has been pointed out to her that it is a cost to the practice either way - they will need to pay to offload me or they will need to find another physician to do my work. This was said calmly and factually by both of us, no threat, no ultimatum. For the time being, she will oversee what I do spend my time on apart from documentation and try to determine how much more help I can get with it (who else could do the reporting of lab results, for instance - do I need to write out every detail for the medical assistant or does saying "normal labs - go over numbers" convey sufficient information to get the right report in the right detail to the patient). She has told me that the most senior doc has his medical assistants pre-prepare all of his lab results (he gets nothing raw) so that he can quickly see what has changed based on what therapies he's tried for a patient and it saves him time looking this up. It might help if I had the same processed information provided to me.

Anyway, at least there are some short-term efforts to streamline that will get started right away. The long-term questions remain to be addressed, and there is not yet a solution for having to continue to document patient encounters myself. But I will accept any efforts made to help lighten my load and will allow time to tell whether it is sufficient or not. Even if I left the practice, I would very much rather NOT do so in frustration and heat - I am very willing to say dispassionately that it did not work out as envisioned, should it come to that. Today's out-of-office conversation was a start.

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