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Who’s Afraid of an EMR?

In reporting this month’s feature on EMR myths, I realized my sources were debunking one of the most enduring healthcare IT myths of all: the physician resister. According to the stereotype, physicians are an intransigent group devoted to paper charts and outdated processes. They are often dismissed as Luddites, and it is assumed that the “physician issue” will be one of the thorniest of any IT implementation.

After years on this beat, I can attest that the most vocal—and passionate—advocates of clinical IT are invariably physicians. And they’re not all technophiles right out of residency, either. Take James Holly, M.D., one of my favorite electronic medical record mythbusters. He’s a healthcare veteran who has been practicing medicine since before anyone heard of the Internet. I first interviewed him several years ago, long before EMRs became fashionable. He insisted then that clinical decision-making could only be enhanced by electronic tools such as online practice guidelines. He has clung tenaciously to this theme and, if anything, has become even more vocal in its support. When I requested an interview for my story, Dr. Holly barraged me with e-mails detailing multiple misconceptions about EMRs.

Nevertheless, any physician skepticism that does exist about clinical IT is not so difficult to understand. It could be that IT vendors are unwittingly contributing to the problem; their claims about the magical powers of their software just make physicians turn tail. At IT trade shows, vendors sometimes showcase their products in lavish booths teeming with chirpy staff and glib magicians. That may not resonate well with cash-strapped clinicians who are more interested in science than showtime.

But there’s more to physician misgivings than vendor hype. Physicians have to squeeze in so many patients that they have little time to ponder the merits of electronic data sharing. Plus, there are few financial incentives to deliver better care with a costly—and potentially burdensome—EMR. Doctors legitimately question who will derive the benefits of a major capital outlay for technology that will upend tried-and-true practice habits and may not work as advertised. For physicians, analyzing workflows and fixing software will never surmount analyzing symptoms and healing people.

—Gary Baldwin