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Baby Boomer Docs and "show me the money"

November 1, 2007
by James Feldbaum
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The Associated Press reported today that the Bush administration is recruiting about 1,200 doctors nationally to adopt an EMR in their medical practice in return for higher Medicare payments. Medicare will pay the physicians extra for completing tasks online, such as when ordering prescriptions or recording the results of lab tests. The highest payments will go to those physicians who most aggressively use the technology and who score the highest in an annual evaluation.

Only about 10 percent of doctors in solo or small-group practices have an EMR. Upfront costs for putting an EMR in place can be prohibitive. “They are saying: 'Look, what's in this for me? My practice is working OK as it is. I need to have some benefit,” Health and Human Services Secretary Mike Leavitt said. "And they are right."

They are suggesting that participating doctors could see their reimbursements increase by several thousand dollars annually when they treat Medicare patients. The administration has also contacted insurance companies and asked them to consider similar rate increases for participating physicians. That way, doctors would have more incentive to participate.

Interestingly, this not unexpected announcement came at the same time that a recent survey was released showing that 48 percent of physicians between 50 and 65 years of age are planning to reduce or end their clinical practice in the next 1 to 3 years. "When Baby Boom doctors entered medicine they had control over how they practiced and the fee they charged. But the rules changed on them in mid-stream and now many are looking for a ticket out," Mark Smith, executive vice president of Merritt Hawkins & Associates, said in a statement.

Why should a physician who has an eye on the exit spend the time and resources to convert decades of paper charts to an EMR. Many “older” physicians lack the computer skills of the younger generation.

Is the EMR a source of dissatisfaction for “Baby Boomer Docs”? Should physicians trust Federal and private payors to come up with promised cash?

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James Feldbaum

Jim Feldbaum is a physician consultant specializing in clinical transformation, CPOE, and...