“Welcome back health care fans!  I’m Dr. Rob.”

“And I’m Dr. Rob’s evil twin.”

“Good to see you again, Dr. Evil”

“Nauseated, as always, to see you, Dr. Rob.  We’ve got a thrilling lineup in store for you tonight, as the Washington Senators take on the Mighty Docs in the third round of the meaningful use playoffs.”

“Don’t you mean payoffs, evil twin?”

“Hilarious, Dr. Dufus.  The meaningful use series did promise big payoffs and better care. But while the first two rounds have resulted in some financial payoffs for a reported 456,000 physicians, the Docs have formally protested, saying that the rules of the game are getting far too complicated, and the other team in this contest, the Patients, have protested that they’re not getting enough playing time.”

“Yes, the Patients have seen playing time steadily diminish, while the new kids in town, the EHRs are getting more and more.  This has gotten so bad that many fantasy health care leagues have replaced the Patients’ roster spot with an extra EHR support staff or insurance coder. The Docs have been on the offensive in Washington, claiming that the EHRs aren’t playing fair.  They claim the lack of interoperability makes it impossible to work along with teammates.”

“This has caused quite a stir in the EHR league.  Right, ugly brother?”

“Absolutely, sinister sibling.  While many teams in the EHR league are willing to look into fixing this problem, the team that is dominating the standings, the Wisconsin Epics, seems pretty quiet on the issue.  Other teams in the league claim that a lack of interoperability gives the Epics an unfair advantage, and so they refuse to cooperate.”

“So, will this derail the Docs’ hopes of spoiling the Senators’ hope of completing the meaningful use triple crown?”

“You’re mixing sports metaphors, bro.”

“Just answer the question, quack!”

“No, I don’t think it will derail the inevitable completion of the series.  Despite the usual infighting among teammates, the Senators are likely to stop stage 3 from going into effect, despite strong objections from both the Docs, Patients, and the Hospital Systems.”

“I always thought ‘Hospital Systems’ was a crazy name for that team.  It makes it hard to root for them.”

“That’s one place where we agree, brother.  It beats the ‘Fabulous ACOs,’ though.  So, if the law does go into effect, what will be the repercussion on the final standings?”

“Certainly if the Epics continue to play their own game, it will make them the big winners.  The Docs and Hospital Systems will continue to struggle, and the Patients, as always, will be at the bottom of the standings.  But even if the Epics join the other EHR league teams, many feel that the Docs and Hospitals will have a hard time scoring, and that many of their players will spend lots of time in the penalty box.”

“Add to that the ICD-10 conversion marathon scheduled for this fall, and I don’t expect the Docs to get above .500 anytime soon.  It’s easy to see why an increasing number of players are bolting to the independent DPC league.”

“You bet, Rob, the rules in that league are much simpler, and the patients seem to fare far better.  But it will take a whole lot more defections before that league makes much of an impact on the system.  It’s hard to see them making much headway against the deep pockets of the established leagues.”

“I agree, Evil. We’ll just have to wait and see what develops.”

“Well, that wraps it up for this evening’s show.  Tune in tomorrow for what promises to be a lively match between the Insurance Companies and the Robotic Surgeons. Until next time, I’m Dr. Evil.”

“And I’m Dr. Rob.  Goodnight and good health.”

Rob Lamberts is an internal medicine-pediatrics physician who blogs at Musings of a Distractible Mind.