Letters to the Editor - Sept. 10, 2007

Pen and paper still best for now

Regarding: "EMRs don't guarantee quality care" (AMNews, Aug. 13): Glad to see that a study of 50,000 records revealed that pen-and-paper physicians can and do still get the job done right. Having lived through the expense of an electronic medical record system with a vendor that went bankrupt, I will not rush back to the EMR yet.

I don't know of any physicians who aren't digital, for filing, accounting and getting paid. I also don't know of any industry where the boss does all of the typing; certainly the last time I used a bank, it was not the CEO entering my deposit.

The biggest failure so far in the EMR is that the physician has become the transcriptionist, and unless one is very fast at the keyboard, that is a waste of valuable time.

As a gynecologist, I found that a templated visit left much to be desired. I am still waiting for true voice-recognition software and until then, I will depend on the skill of a good typist.

In the meantime, I remain as president, CEO, IT specialist, computer builder, network and software supplier, and in between all of this, physician and healer.

--Robert Frischer, MD, Wichita Falls, Texas

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Forcing physician to e-prescribe would create a "financial burden"

Regarding: "Pharmacy benefit managers push Medicare e-prescribing" (AMNews, Aug. 13): Any move to force e-prescribing will be a financial burden on physicians and a windfall for pharmacy benefit manager profits.

The real problem for the medical profession is that there is no one universal system that will be compatible with all pharmacies in a true electronic form, such as e-mail.

Any move in this direction that is piecemeal will only allow the pharmacy benefit manager to eliminate clerks who make errors in filling the prescriptions. We observe this problem almost daily.

If the doctor does the work, there will be fewer errors, but we will bear the cost both in time and equipment.

I can still write much faster than I can use a computer to prescribe.

I tried a system several years ago and stopped, due to cost and inefficiency. Merely loading e-mail addresses and patient information into a system and making sure the patient has not changed every time he is seen will add too much to cost of service.

We already see Medicare patients at a loss. Any more cost will drive us out of the system, especially when fees are due to be cut. Besides, my pocket PC and ePocrates program give me all the interaction information I need.

--William A. Delp, DO, Loganville, Ga.

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