Government-Mandated EMR

The economic stimulus package includes “incentive” money for doctors who adopt Electronic Medical Records. This is not a positive thing.

Don’t get me wrong. Private money for good doctors is entirely appropriate. It’s the governmental involvement that scares me. Its record isn’t exactly one that inspires confidence that the people running things have any clue about sound decision making or effective management.

An example with which everyone is familiar is shipping.  If I want to send a package, I can take it to the post office, pay some money to a government employee, and eventually the package will probably arrive at its destination. If I specify that it is urgent that the package arrive the next day, I can pay extra. The postal service will not guarantee next day service, but they are willing to take money so that you can have a “next day” sticker on your package. In fact, one time it took a full week for a “next day” package to be delivered to a business 70 miles from my company. No apology, no reimbursement – bad service with an attitude to match. If a package goes astray, nobody has any idea where it might have gone. Contrast that with UPS and FedEx. Both of these companies understand that good service equates to repeat business. At any time, I can go online and learn the exact location of every package – from the moment it is shipped until the moment it arrives at its destination. The reason so many companies use these shippers is that they do a better job. Private industries are able to provide superior service and be profitable while charging less money.

If the post-office were an anomaly, the government might be forgiven. It’s not. Government is not good at figuring out the best way to accomplish a task. Government is good at setting up red-tape bureaucracy.

Another example is our educational system. Private schools spend less per student than public schools, yet students at private schools receive an education superior to that of their publicly-educated peers. Why? Because “more money” doesn’t equal “better product.”

The government powers-that-be just don’t get it. Extra regulations and management require extra money while negatively affecting the product delivered. Given the government’s track record, I want it kept as far from my medical care as possible!

A basic principle that has worked well for our country is that businesses will adopt strategies if they are a good way to conduct business, and they will eschew practices that hurt. Some of us remember when doctors did their scheduling in a huge book – appointments were hand-written in pencil. I don’t think anyone does that any more. Why? Did the government tell doctors to buy computers and scheduling software? Doctors invested in computerized scheduling because it is better than the old system. That same principle should drive EMR adoption. If it is a better way to run a medical practice, then doctors will switch of their own volition.

EMR implementation should not be forced. The government has no business telling doctors how run a medical practice.