Skip to content
  • About
  • Contact
  • Contribute
  • Book
  • Careers
  • Podcast
  • Recommended
  • Speaking
  • All
  • Physician
  • Practice
  • Policy
  • Finance
  • Conditions
  • .edu
  • Patient
  • Meds
  • Tech
  • Social
  • Video
    • All
    • Physician
    • Practice
    • Policy
    • Finance
    • Conditions
    • .edu
    • Patient
    • Meds
    • Tech
    • Social
    • Video
    • About
    • Contact
    • Contribute
    • Book
    • Careers
    • Podcast
    • Recommended
    • Speaking

Click, click, click: How can I help you today?

Stewart Segal, MD
Physician
November 26, 2012
Share
Tweet
Share

Click, click, click, “Hello, how are you today?”

Click, click, click, “How long have you had a sore throat?”

Click, click, click, “Have you had a fever?”

Click, click, click, “Have a seat on my exam table, please.”

Click, click, click, welcome to my day.  Let me introduce myself, I’m a professional clicker.  I used to be a member of a highly respected and sought after profession; a doctor.  The modern world of government/insurer managed healthcare has turned me into an efficient clicker, busily documenting everything I do so that I can:

  • Be reimbursed for my services
  • Afford to pay my staff/landlord/utility/self
  • Avoid being prosecuted for fraud by Medicare
  • Avoid lawsuits
  • Communicate with other docs
  • Meet “quality” parameters set by Medicare/insurers

Being highly educated, my colleagues and I are easily trainable and have reached the pinnacle of “clicking.”  Now, Medicare and the New York Times are on the attack.  They are questioning if docs are “gaming” the system to receive higher pay.  They are questioning our ethics.

First of all, we did not create the system/game.  At every step of the way, we have been forced to play by Medicare’s and the insurers’ rules.  Not only have we been forced to play by their rules, we have also been forced to shoulder the expense of buying and learning to use the EMR (electronic medical record) that many of us did not want to use.

Second, the EMR made it easy to record what we never recorded in the past.  It’s hard to exam a person without examining his/her skin.  Acne and blemishes, skin color, texture and warmth are readily apparent.  In years past, only positive findings would have been recorded in my patient’s paper chart.  Now, click, click, click and it’s all recorded electronically.  In the old days, I knew what my notes meant.  Now, the rule is:  If it’s not recorded, you didn’t do it.

Click, click, click,  and everything I do is recorded.  Every click satisfies the rules Uncle Sam and the insurers of America have forced down our collective throats.  Does all the clicking improve medical care?  I think not.  Has all the clicking saved money?  Most definitely, it has not. Am I making more money?  Definitely not.  The upkeep and expenses associated with clicking is immense.

So, who profits?  No one.  If no one profits, why are we doing it?  We are clicking because we are being forced to click.  In 2014, we will be financially penalized for not clicking.  Now, we may be penalized for being too good at clicking.  The government is on a witch hunt looking for fraudulent clickers.  Sometimes, you can’t win.

One more question needs to be answered.  Clicks are data points and are being collected every minute of the day by Medicare and the insurers.  What’s being done with all that data?  That question is the one keeping me awake at night.

Click, click, click, “Good morning, how can I help you?”

Stewart Segal is a family physician who blogs at Livewellthy.org.

ADVERTISEMENT

Prev

Mean doctors and nice nurses: It's time to change our brand

November 26, 2012 Kevin 84
…
Next

Income inequality among physicians should matter to patients

November 27, 2012 Kevin 7
…

Tagged as: Health IT, Primary Care

Post navigation

< Previous Post
Mean doctors and nice nurses: It's time to change our brand
Next Post >
Income inequality among physicians should matter to patients

ADVERTISEMENT

More by Stewart Segal, MD

  • a desk with keyboard and ipad with the kevinmd logo

    I dream of practicing free medicine

    Stewart Segal, MD
  • a desk with keyboard and ipad with the kevinmd logo

    I have a problem and my problem is me

    Stewart Segal, MD
  • a desk with keyboard and ipad with the kevinmd logo

    Our medical system needs more positive stories

    Stewart Segal, MD

More in Physician

  • Why Canada is losing its skilled immigrant doctors

    Olumuyiwa Bamgbade, MD
  • Why doctors are reclaiming control from burnout culture

    Maureen Gibbons, MD
  • Why screening for diseases you might have can backfire

    Andy Lazris, MD and Alan Roth, DO
  • Why “do no harm” might be harming modern medicine

    Sabooh S. Mubbashar, MD
  • International doctors blocked by visa delays as U.S. faces physician shortage

    Arthur Lazarus, MD, MBA
  • How I redesigned my life as a physician without abandoning medicine

    Ben Reinking, MD
  • Most Popular

  • Past Week

    • Why are medical students turning away from primary care? [PODCAST]

      The Podcast by KevinMD | Podcast
    • Here’s what providers really need in a modern EHR

      Laura Kohlhagen, MD, MBA | Tech
    • Why “do no harm” might be harming modern medicine

      Sabooh S. Mubbashar, MD | Physician
    • How community paramedicine impacts Indigenous elders

      Noah Weinberg | Conditions
    • Why Canada is losing its skilled immigrant doctors

      Olumuyiwa Bamgbade, MD | Physician
    • How to speak the language of leadership to improve doctor wellness [PODCAST]

      The Podcast by KevinMD | Podcast
  • Past 6 Months

    • Why tracking cognitive load could save doctors and patients

      Hiba Fatima Hamid | Education
    • Why are medical students turning away from primary care? [PODCAST]

      The Podcast by KevinMD | Podcast
    • Why “do no harm” might be harming modern medicine

      Sabooh S. Mubbashar, MD | Physician
    • Here’s what providers really need in a modern EHR

      Laura Kohlhagen, MD, MBA | Tech
    • What the world must learn from the life and death of Hind Rajab

      Saba Qaiser, RN | Conditions
    • How medical culture hides burnout in plain sight

      Marco Benítez | Conditions
  • Recent Posts

    • Why Canada is losing its skilled immigrant doctors

      Olumuyiwa Bamgbade, MD | Physician
    • Why doctors are reclaiming control from burnout culture

      Maureen Gibbons, MD | Physician
    • Would The Pitts’ Dr. Robby Robinavitch welcome a new colleague? Yes. Especially if their initials were AI.

      Gabe Jones, MBA | Tech
    • Why medicine must stop worshipping burnout and start valuing humanity

      Sarah White, APRN | Conditions
    • Why screening for diseases you might have can backfire

      Andy Lazris, MD and Alan Roth, DO | Physician
    • How organizational culture drives top talent away [PODCAST]

      The Podcast by KevinMD | Podcast

Subscribe to KevinMD and never miss a story!

Get free updates delivered free to your inbox.


Find jobs at
Careers by KevinMD.com

Search thousands of physician, PA, NP, and CRNA jobs now.

Learn more

View 10 Comments >

Founded in 2004 by Kevin Pho, MD, KevinMD.com is the web’s leading platform where physicians, advanced practitioners, nurses, medical students, and patients share their insight and tell their stories.

Social

  • Like on Facebook
  • Follow on Twitter
  • Connect on Linkedin
  • Subscribe on Youtube
  • Instagram

ADVERTISEMENT

  • Most Popular

  • Past Week

    • Why are medical students turning away from primary care? [PODCAST]

      The Podcast by KevinMD | Podcast
    • Here’s what providers really need in a modern EHR

      Laura Kohlhagen, MD, MBA | Tech
    • Why “do no harm” might be harming modern medicine

      Sabooh S. Mubbashar, MD | Physician
    • How community paramedicine impacts Indigenous elders

      Noah Weinberg | Conditions
    • Why Canada is losing its skilled immigrant doctors

      Olumuyiwa Bamgbade, MD | Physician
    • How to speak the language of leadership to improve doctor wellness [PODCAST]

      The Podcast by KevinMD | Podcast
  • Past 6 Months

    • Why tracking cognitive load could save doctors and patients

      Hiba Fatima Hamid | Education
    • Why are medical students turning away from primary care? [PODCAST]

      The Podcast by KevinMD | Podcast
    • Why “do no harm” might be harming modern medicine

      Sabooh S. Mubbashar, MD | Physician
    • Here’s what providers really need in a modern EHR

      Laura Kohlhagen, MD, MBA | Tech
    • What the world must learn from the life and death of Hind Rajab

      Saba Qaiser, RN | Conditions
    • How medical culture hides burnout in plain sight

      Marco Benítez | Conditions
  • Recent Posts

    • Why Canada is losing its skilled immigrant doctors

      Olumuyiwa Bamgbade, MD | Physician
    • Why doctors are reclaiming control from burnout culture

      Maureen Gibbons, MD | Physician
    • Would The Pitts’ Dr. Robby Robinavitch welcome a new colleague? Yes. Especially if their initials were AI.

      Gabe Jones, MBA | Tech
    • Why medicine must stop worshipping burnout and start valuing humanity

      Sarah White, APRN | Conditions
    • Why screening for diseases you might have can backfire

      Andy Lazris, MD and Alan Roth, DO | Physician
    • How organizational culture drives top talent away [PODCAST]

      The Podcast by KevinMD | Podcast

MedPage Today Professional

An Everyday Health Property Medpage Today
  • Terms of Use | Disclaimer
  • Privacy Policy
  • DMCA Policy
All Content © KevinMD, LLC
Site by Outthink Group

Click, click, click: How can I help you today?
10 comments

Comments are moderated before they are published. Please read the comment policy.

Loading Comments...