Can young doctors tolerate EHRs more than their older counterparts?
Part two of the first ever Physicians Practice Young Doctors' Roundtable looks to answer this question and much more. Part one touched upon why the three doctors went the independent practice route, if medical school debt weighed on their minds, and biases they've faced as young physicians.
We dug even deeper for part two, looking into if physicians who grew up in the age of computers can better tolerate current EHR offerings. We also found how much they value work-life balance and why young docs should consider using a lawyer to negotiate contracts. Below are excerpts from our conversation.
Our three doctors are:
Elizabeth Seymour, MD, 34, family medicine, Denton, Texas
Landon Roussel, MD, 32, direct primary care internist, Luther, La.
Brandi Ring, MD, 35, obstetrician/gynecologist, Denver, Co.
As a younger generation, you grew up on computers. What do you think of EHRs?
Elizabeth Seymour: Generally we understand, we've been exposed. In residency, they still had paper. We went through the EHR transition while I was there. For the first six months I was in clinic, we were all writing. I hated it. My hand got tired. I didn't leave until 6:30 at night….I didn't like it and didn't want to do that for the rest of my life. Then they implemented the EHR and I thought it was the best thing since sliced bread. In the last 11 years, being in and out of residency, I've dealt with older physicians, specialists, who don't use the EHR. It's frustrating. I can't read their notes. I don't know what's going on. That's shifted my referrals. If I can't read your note, I'm not going to waste my time trying to figure out if something is a “T” or a “J.”
I like the EHR, but I will say there is a lot more clicks, more documentation. It kind of becomes brainless, where it's click this/check that. Sometimes that takes away from your thought process of looking at your patients and connecting with them and remembering things about them. Personally I'll think, I didn't use my brain [because of the EHR] and I have to think further outside my box. What could a symptom be besides something common? I don't think the EHR helps with that.
Landon Roussel: In terms of adapting to the EHR, it's never been a problem. I grew up in the computer age and took a programming class in junior high. I found for my direct primary care (DPC) practice, when I started doing DPC and documented for my own sake, and maybe medical and legal reasons, the way we were charting in residency included a lot of unhelpful things. It didn't reflect what was going on with the patient and what needs to be done. What's enlightening is having a prolonged relationship with the patient, to where you use the EHR as an assistance. You can't remember details that you can't possibly hold in memory. But [in DPC] it's not the end all, be all of the doctor-patient relationship. It's a part of our ongoing primary-care relationship.
When I document for Medicare purposes, you see how much excess is being imposed on providers for the sake of data mining. It's getting in the way of the doctor-patient relationship and requiring us to do more work without the sake of being a benefit to the doctor, patient or the system as a whole.