Monday, April 28, 2014

Mandates Killing California Solo Practice

The San Diego Union-Tribune reports, "Obamacare deals blow to one-doctor medicine".

One major problem has been the mandated electronic medical records.  From the article:
In a slow-motion version of the problems that crippled online insurance “exchanges” for months, doctors who see patients under Medicare and Medi-Cal programs have been forced by the phase-in of a 2009 federal "stimulus" law to install expensive, complex software systems that sharply reduce time for patients...

Nearly 70 percent of physicians say digitizing patient records has not been worth the cost, according to a survey by Medical Economics magazine. This negative cost-benefit view comes even after $27 billion in subsidies to health care providers for the systems.

One big problem is the dozens of systems don’t talk to each other, because the feds didn’t mandate interoperability before the rollout.

So communication gains among hospitals, clinics and doctors offices aren’t happening. Adding insult, doctors can be criminally liable if hackers get hold of patient data.

Worse is the hit to productivity. Doug says he once aimed to see four patients an hour for normal office visits. Now he struggles to see three each hour, and colleagues report much the same...
The article also notes: "Still, the mandates clearly shift advantage to large doctor groups and health systems that can amortize costs over more patients" and "So far, nobody knows if the move to factory-style medicine will improve the quality or cost of care."

We'll find out soon enough.