Rather than face the perfect storm of decreasing reimbursement, increasing costs, legislative mandates, and penalties around technology adoption, information exchange, and Meaningful Use, an alarming number of physicians are making the decision to "go quietly into the night" and retire early from practice.
Some are leaving the profession as many as 10 years earlier than they had anticipated. Rather than consider change, physicians are placing a DNR on their practices, saying no to investing in tools necessary to efficiently manage their businesses. For some physicians, the hospital's own IT transformation activities are the tipping point driving them to retire. We need to do something about this problem before it's too late.
Physicians are trained to make decisions, not ask questions--except of patients. The noble personality that gives them the confidence to heal also causes them to feel they have to be all-knowing and all-seeing on all topics. Many physicians are not comfortable publicly sharing their questions about technology selection, adoption, or optimization--fearing it will expose ignorance about topics on which they believe their peers have all the answers. Yet with so little time just to keep up with clinical research in their own specialties, when do physicians have time to become IT experts as well?
Consider what happens when physicians experience an adverse outcome. Unless they're residents or are in a behind-closed-doors peer review, they're not encouraged to expose the troubling issue so they can brainstorm with their peers to improve their clinical decision-making. For fear of retribution by attorneys representing patients or grieving families, they have been trained to suffer in silence and guess at what might have happened and/or what they might do differently next time.
Unfortunately, many physicians apply that same learned response to their selection, implementation, and adoption of EHRs. They don't openly discuss their questions, concerns, thought processes, and experiences as they evaluate technology. Nor do they share best practices or lessons learned while adopting and utilizing new health record tools and processes. Instead, they kick into "fight or flight" mode during EMR implementation, too often letting their practices quietly flat-line.
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In my view, physicians fall somewhere between a national treasure and natural resource, and one that's becoming an endangered species. Fewer physicians are encouraging their children to go into medicine, unsure of the future reward for all the risk. Physicians are deciding to retire early, afraid to change, unwilling to learn something new, and unsure if they can. While your first instinct as an IT manager may be to push forward with your hospital's EHR implementation without them--don't. You may not realize exactly how much impact on care they are providing in your community.
Hospitals have a license to house patients; physicians have the license to treat them. It is only by working together that we can continue to provide care in our community. If physicians go, who will step in to provide care to those patients? With empathy and the right engagement, these physicians will ensure the successful adoption and utilization of the technology needed to ensure your organization not only survives but also thrives during these turbulent times.
Huntington Hospital, where I serve as executive director, physician & interoperability services, is working with physicians in our community to help them consider their options, share their experiences, best practices, challenges, and missteps, and figure out how to create efficient workflows.
