Universal healthcare you say…. let me give you some history as a physician.

Several years back, the government rolled out a plan designed to incentivize physicians to get electronic health records (EHR). They offered to subsidize the cost of an EHR if the physician purchased a “compliant” electronic health record. (Carrot) They called this their “meaningful use” initiative.

According to the definition of “meaningful use,” an EHR is compliant if the physician using it makes his/her data back-door accessible to the government. In common parlance, however, making meaningful use of an electronic tool has nothing to do with allowing third-party access to the data collected in that tool.

I didn’t feel right about sharing that kind of private information, but I worked for a hospital at that time, and they needed the money to purchase the new, expensive EHR (which decreased efficiency by at least 20-30% and contributed to physician and nurse burn out by 100%) so they could take advantage of the carrot instead of the stick (see below). I asked what the hospital/the government was going to do with this data. They could not tell me. I said it was wrong. They didn’t care.

Since then, the government has continued to inundate the healthcare industry with collectible data-points, creating more useless burden on the physicians who often end up hiring additional staff to click boxes and put in data. Meanwhile, there is a mass exodus of physicians. (see this NPR article)

Once the government had lured as many providers as possible with the carrot, they implemented policy saying “if you do not purchase a compliant health record, we will lower your reimbursement by x percent per year for so many years.” (See the stick?) Furthermore, regulators tell us that if we do not put in the data points they require, they will consider us a poorly performing physician and further lower our reimbursement. (Another stick that they call their “pay for performance” initiative.) As a result, even more physicians leave healthcare.

Still no word on what they’re planning on doing with your data.

Voyage Direct Primary Care uses an EHR that does not comply with “meaningful use” protocols. Heather and I are not compliant with governmental “Pay for performance” initiatives. Our patients’ data has never been more secure, however, and I’ve never been happier. But most importantly, I’m able to deliver way better care now, and I’ve fallen back in love with my profession.

-Dr. John