03/04/2014    Michael DeVito, DPM

Technology May Put Private Practice Into Extinction (Joseph Borreggine, DPM)

I very much feel similar to Dr. Borreggine, so
much so that I went to the e-advocacy on APMA and
sent letters to my congressman about the
legislation requesting hardship exemption from EHR
penalty for small practices. Hopefully, others
will do the same, everyday until they hear us. I
never felt specialists should be reporting the
same as PCPs/internists. If the reporting was more
tailored to our needs, it would be easier take all
of this.

I may be incorrect, but have been told stage 2 MU
has significant hurdles to overcome including
costs for encryption and additional costs for
Patient education from a “certified vendor.” It
was not enough that my patient Education sheets
had to be reconfigured in the EMR and then
reprinted to hand to a patient to get credit, but
now we have to pay someone else to get certified
education material.

There are good things about our new found EHR
technology but there are many things that are
slowly destroying the small private practice and
the quality care they deliver because of the
impossibility to keep up. It is not just the
doctors that are bogged down, the entire staff is
glued to their computers clicking and verifying
and checking all the measures to meet meaningless
uselessness. When you add it all up it is not
worth the toll it is taking on the office.

I know many have said it is not about the
financial incentives, rather about providing
better quality care. Let’s take our next poll to
see if Doctors feel they provide better care in
this MU world created. The MU process needs
streamlined and improved as it is out of control.
Next time your internet goes out, turn off all the
computers get back to the basics and think about
how nice it was providing care without the
reporting & EMR technology around.

The proposed new SGR formula says they are likely
eliminating meaningful use and PQRS reporting (not
soon enough). It is quite clear we did not realize
the detail of reporting and the resources required
for these next stages. If we abandon MU after 2
phases of stage 1 and give up now what happens?
Will penalties carry over to the new payment
system or will things be adjusted?
What is in Stage 3? Maybe they don’t want us to
know because we would all abandon it now before
dragging this out 3 more painful years.

I understand the need for ICD-10 and even the PQRS
reports with a few measures here and there, but
the MU reporting program was not well thought out
for small physician practices and is completely
impractical. And when you combine them all, at the
same time, in the same year, (when even your
software vendors can’t keep up with all the
changes), we cry uncle.

I for one don’t care anymore about the threats of
the 5% penalty, I’ll use the EMR the way it works
for me. Maybe this was the intention all along to
narrow the networks and get Doctors to drop out of
the Medicare system by punishing them 2% here for
eRx, then 2% there for PQRS and bam another 5% for
MU. Who in medicine agreed to this nonsense?
We will wake up one day and ask what happened to
all the good doctors in private practice? They
were knocked out by the 1,2,3 punches of an
American healthcare system caught up in reporting
and not caring for patients.

Michael DeVito, DPM, Chicago Ridge, IL,
Drd@devitofootdoc.com

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