COMMENTARY

Should You Lose Your License if You're Not Computer Savvy?

Arthur L. Caplan, PhD

Disclosures

January 29, 2018

Hi. I'm Art Caplan at the Division of Medical Ethics at the New York University (NYU) School of Medicine. Anna Konopka is an 84-year-old physician who was practicing primary care in New Hampshire, much liked by her patients, but she suffered a particular deficit in her skills. She was not computer friendly.

I know that many of you watching are saying: Who is adept at these electronic medical records (EMRs)? Who is it that can avoid spending hours trying to enter information into these supposed time-saving electronic advances? But that wasn't her problem. She basically wasn't computer savvy, computer friendly. She grew up in a time when she didn't have any skills involving computerized medicine.

The New Hampshire Licensing Board said: You can't practice that way. They pulled her license, and she went to court to see if she could get it restored. I don't know the outcome, but she is definitely going to battle the suspension of her license, and I imagine she has a number of patients who are going to go along with that as well, saying that a pen and paper system the way she used it is perfectly fine with them.

I think the licensing board was right. You can't practice in the 21st century without any computer skills. It is reasonable for payers and others to expect that you are going to enter information into the blasted EMRs. I get what the limits are; you don't have to email me about that. I understand that they are horrible, but you have to have some skill for billing and to keep tabs on patients and to work with other doctors. You've got to create that electronic footprint.

My suggestion isn't to take her license away. It's to hire some computer-savvy scribe to help her enter that stuff. She doesn't have to learn those skills at this point in time, and she can work with a partner or someone else who is capable of doing that for her. She should keep her license. She clearly is a valued member of the community, and no one is suggesting that she is not up to being a good doctor, but good doctors today need to have some computer savvy.

If they can't have it because of disability or age, then the mission becomes to get them the help they need so that they can continue to practice.

I am Art Caplan at the Division of Medical Ethics at the NYU School of Medicine. Thanks for watching.

Talking Points: Should You Lose Your License If You're Not Computer Savvy?

Issues to consider:

  • 30% of EMR system implementations fail, often because physicians cannot use the EMRs efficiently.[1]

  • Many healthcare professionals contend that there is a connection between EMR use and better care. If a patient becomes sick after hours, a physician can use an EMR to remotely view the patient's records, and computerized health records can be easily shared with other providers.[1]

  • Many costly medical errors, including prescription errors, could be eliminated with electronic systems.[1]

  • Beginning users of EMRs are often confused because of the enormous range of functionality offered by EMRs as well as the navigational structure of the EMR system. It takes time for beginners to understand what can be done and how to do it.[2]

  • EMRs have resulted in increased documentation burden, with physicians spending up to 2 hours on EMR-related tasks for every 1 patient-care hour.[3]

  • Employing medical scribes has enhanced clinical documentation, improved revenue collection, increased physician satisfaction, and reduced burnout in many specialties.[3]

  • According to the Centers for Disease Control and Prevention, 86.9% of office-based physicians are using an EMR/EHR system.[4]

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