The same CBC article (on Canadian doctors’ love-hate relationship with EMRs) that featured Dr. Greiver’s EMR also published this comment that didn’t sit very well with me:

"Let’s be honest," says researcher Dave Ludwick. "Doctors have gone to school to become doctors, to understand how the body works and remedy that body’s failings, not to do IT. And yet with electronic records, IT suddenly becomes their job, too."

I am aware that this doesn’t exactly say that IT isn’t the physician’s job, but it’s certainly implied.

So what gives? Why the downer attitude?

If all jobs matched their job descriptions, the world would be a very foreign place.

Then I thought about the “description”…

In Canada, we have a famous diagram of the CANMEDS competencies (“a guide to the essential abilities physicians need for optimal patient outcomes”):

Indeed, our medical schools are crazy about this flower. Pre-medical and medical students do their utmost to present themselves as embodying these traits. You don’t get a more widely-accepted job description here than this…

And I think that every single petal is relevant to the EMR debate.

Don’t get me wrong; implementing an EMR can’t be easy. Even a cursory read of Dr. Greiver’s blog turns up painstaking detail on the frustrations, including power outages, hardware upgrades, hardware failure, and the inevitable comparison with non-EMR physicians… And for Mr. Ludwick, the major worry is that the physician is juggling too many balls: "We are concerned that physicians do not have sufficient computer skills to take notes and navigate an EMR while listening to a patient in an encounter.”

Fair enough. But then we also have to ask ourselves: what does the word “manager” entail?

How can one claim to be a good “communicator” and “collaborator” if you bury your head in the sand at the first sign of difficulty? How do you even effectively argue against EMR if you’re not being a “scholar” and following the developments? How relevant is a “health advocate” who doesn’t know what his patients find when they Google this stuff (and they will!)?

Computer skills is not the issue.

I was under the impression that in the real world, we don’t “have” specific skills; we “develop” them. I wonder if it really is about attitude.

I like the way this comment on KevinMD’s post A Lack of Computer Skills Will Make a Doctor Unemployable puts it:

The issue is not how willing are physicians to tie themselves to bad products, it is how willing are they to spend time researching technology, implementing good systems, and completing daily activities on computers.

And this doesn’t necessarily mean you have to go out and get yourself an EMR RIGHT NOW:

Nobody said you had to have an EMR system in place to be employable. It was said that you must be able to use a computer for daily activities such as email, viewing, & updating patient information.

 

Now whether your medical records are on paper or are digital is up to you (for right now). But most hospitals and private practices are using some sort of computer system for their day to day operations, and if you can’t manage that skill set you are going to have a tough time competing with your fellow physicians.

In conclusion: please stop pulling petals off the flower. Surely we can do better than that.

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