The Canadian woman looked nice
I said the doctors here seem in a trice
She nodded and listened
While our system was dissened
The regulations come at a price.
Synopsis: I’m a Family Practitioner from Sioux City, Iowa. In 2010 I danced back from the brink of burnout, and honoring a 1 year non-compete clause, travelled and worked in out-of-the-way places in Alaska, Nebraska, Iowa, and New Zealand. After three years working with a Community Health Center, I am back having adventures in temporary positions until they have an Electronic Medical Record (EMR) system I can get along with. I spent the winter in Nome, Alaska, followed by assignments in rural Iowa. This summer included a funeral, a bicycle tour in Michigan, cherry picking in Iowa, a medical conference in Denver, and two weeks a month working Urgent Care in suburban Pennsylvania. Any patient information has been included with permission.
On Monday evening I got a call from a recruiter, naming a town where I’d worked that had a sudden need.
Despite the morbid curiosity, I decided I didn’t want to know the drama and irony that had led a colleague to back out of a commitment to work. I recognized the name of the town, I’d worked there before and I enjoyed it. I could walk from the hotel to the clinic. I found a good hot breakfast in between. But within a few hours, I realized that the town had the same name but the job pertained to a different clinic altogether. I said no.
My favorite recruiter asked me to please take the assignment. By way of loyalty borne of our good relationship, I accepted. A flurry of emails followed. I spent four hours filling out forms.
My five-year-old scanner printer stopped working. Which led to a great deal of frustration. Eventually, I photographed six documents with my cell phone and sent them via text.
The next morning found me on my way back to Pennsylvania. I had slept poorly, staying up late trying to get the paperwork taken care of.
At the airport in Chicago, i sat next to an attractive young woman. I glanced at her passport and said “Canadian, eh?” She chuckled. I told her that I was in the process of applying for a Canadian medical license, and she was surprised to learn about the frustrations of American doctors with ou current system. They boil down to four: electronic medical records, the meaningful use mandate, medical malpractice, and loss of autonomy.
She could not believe what I told her about the meaningful use mandate. Congress allocated funds for doctors to purchase electronic medical records, and gave them a small incentive to use them. Then, to provide proof that they were being used in a meaningful fashion, the Center for Medicare Services formulated meaningful use regulations, to be phased in over several years. Meeting them costs inordinate hours and has cut productivity of primary care doctors across the board by 25%.
And the regulations keep getting worse.
The conversation turned into a monologue and a rant, if not an outright Jeremiad. But she listened politely, and boarded her plane when called, I think with relief.