Letters to the Editor - Oct. 23/30, 2006

EMRs need not cost $50,000 per doctor - Physicians should take a stand against pharmaceutical promotions

EMRs need not cost $50,000 per doctor

Regarding "Price-posting initiative raises concerns about implementation" (Article, Sept. 11):

Our experience does not reflect the suggestion that the implementation of an electronic medical record system in small to medium practices costs from $20,000 to $50,000 per physician.

I have a master's degree in computer science and I am currently managing the practice that my wife owns here in northern Maine. This is a single physician office that has been using EMR systems for almost five years. Our office, for the most part, is electronically driven. The current EMR system we have is top-notch and cost us just over $5,000 with a yearly support fee of around $600.

If we were to throw in all the bells and whistles that this software system is capable of, including all the hardware necessary to run it, I doubt we would have much more then $8,000 invested (which includes training). The cost per physician would go down with each additional doctor.

The software is fast, extremely flexible, adaptable to the way the doctor practices medicine and, most important to us, stable.

Second, the support is excellent when it comes to problems that we might run into day to day and for the development of software updates. They are currently working on those interoperability issues you mentioned in the article.

This product has a proven track record in other areas of software development and seems committed to growth, consistently doing so since its inception. (I might add at this point that we have no vested interest in the company, nor do we receive any support from them other than the satisfaction and enjoyment of having a product that meets our needs.)

What would be helpful for all of us would be for the AMA to offer a forum for physicians to become aware of companies that are developing EMR software like the one we have.

From our experience, the biggest stumbling block to getting started with an EMR program was finding a good fit between the practice and a good EMR program.

There is a lot of junk software out there that is costly and has little or no support from companies that are not committed to the long haul. We know -- we unfortunately picked such a company the first time around.

--Thomas Richard Shay III, Presque Isle, Maine

Physicians should take a stand against pharmaceutical promotions

When is the medical profession going to wake up to the fact that pharmaceutical promotions and television drug advertising might be decreasing the quality of care our patients receive?

Drug companies would not be promoting new expensive drugs to us or running ads on TV if they were not convinced that they would benefit. They believe that more prescriptions will be written for their products, and fewer written for generics or other less costly alternatives. This applies both to sales pitches by pharmaceutical representatives and to television ads. When pharmaceutical representatives ask if they can count on me to prescribe their medication, they are asking me to compromise medical ethics.

This drives up the cost of medical care, making it more difficult for the uninsured.

Also, when a physician has to spend time answering questions from patients about TV ads, this decreases the time available to deal with medical diagnosis, treatment and real patient education.

Nothing good comes out of drug promotions or television ads. When will the medical profession realize this and take a stand?

--David C. Morris, MD, West Columbia, S.C.

Vote refines AMA stance on health reform
The AMA House of Delegates rejected attempts to rescind support of a U.S. House health reform bill and any new government-sponsored health insurance plan during the 2009 Interim Meeting.
Story - AMA House - Slideshow