My wife and I went out for dinner the other night with our doctor and his wife. Actually, there was nothing unusual about this as we have known them for 25 years as good friends and neighbors. He practices Internal Medicine and I have always known him to be sincere about his work. I've met a lot of physicians over the years, several of whom are out for a quick buck, so it is refreshing to talk to one who is dedicated and takes his work seriously. Knowing of my background in systems and Information Technology he began to tell me about some recent changes in his practice that are affecting the very nature of his work. Frankly, I was disturbed with what I heard.
There are administrative changes underfoot in doctor offices that will ultimately affect us all. In a nutshell, the government is blackmailing doctors to provide extensive data about their patients. If they fail to provide it by certain deadlines, the government will withhold a percentage of their Medicare/Medicaid compensation which can be quite substantial. Even though the doctors realize this will be a burden to them, they also know resistance is futile.
Electronic records management is intended to improve patient health care simply due to the sharing of medical data on a national level. To illustrate, if a patient from Florida who suffers a problem away from home, such as in Ohio, local doctors can easily access the patient's medical records and treat him more effectively. There is only one problem with this, patient records are voluminous thereby making it laborious and time consuming to input.
The new reporting procedures require the doctors to personally review the records of each of their patients and input the data themselves, not an office manager or clerk. When completed, the doctors will be required to continually update the records using computer software. Even after the initial setup of patient data, which is no small task, asking physicians to update the records on an ongoing basis is considered a huge imposition and a distraction tending to interfere with the treatment of their patients. The technology for input is not conducive for simplifying the process and primarily consists of keyboards and mouse pointing devices. Voice-to-text has been around for some time, but it is not nearly at the level of sophistication required by physicians to stay on top of the task.
Another aspect that should be of consideration to American consumers is that the government will now have access to their medical records. They already have access to criminal and financial records, not to mention employment, citizenship and personal possessions (such as automobiles, housing and real estate). Now add in medical history and there will be little else the government will not know about us. Wow, talk about "Big Brother" watching. This should make all citizens gravely concerned about privacy and security issues.
Doctors are already being squeezed by insurance companies and malpractice attorneys. Now the government is going to add another level of bureaucracy to complicate their lives. So incensed are a lot of physicians about this that it appears a whole generation of doctors will likely abandon their practices over the next five years thereby radically disrupting patient care in this country.
"So, how are things in your business?" my Doctor friend finally asked.
I replied, "Not nearly as bad as I thought."
Keep the Faith!
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Tim Bryce is a writer and the Managing Director of M. Bryce & Associates (MBA) of Palm Harbor, Florida and has over 30 years of experience in the management consulting field. He can be reached at timb001@phmainstreet.com
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Copyright © 2011 by Tim Bryce. All rights reserved.
This weekend marks the thirtieth wedding anniversary for my wife and I, which many consider quite a milestone, particularly in an age where 40-50% of first time marriages end in divorce. We've already had a lot of people congratulate my wife and myself on this achievement as if we had just swum across the English Channel. Frankly though, we don't understand what the hubbub is all about. After all, this is what we signed up for and we're in it for the long haul. As an aside, I tend to appreciate anniversaries more so than birthdays as I, at least, had something to say about getting married.
I recently attended a training session for a nonprofit organization whereby the intention was to teach new members the policies and procedures for the organization. I was there to assist. During the course of the program, the instructor explained the protocol for conducting meetings where the public may be in attendance. In addition to "Roberts Rules of Order," the group had supplemental procedures for recognizing and answering questions from the floor. All of it seemed rather simple and straightforward, but there were a couple of young people in attendance, whom I judged to be in their mid-20's, who seemed to be baffled by the instructor's explanation. The teacher patiently repeated the procedure and demonstrated with some examples. This didn't seem to help as the students were still at a loss as to what the instructor was saying. At this point, other students chimed in to support the teacher and tried to explain the concept to them. I even threw in my two cents. After much cajoling, they finally acquiesced and claimed they understood, but I wasn't convinced they did.
We don't play a game of cards much anymore, games like Bridge, Pinochle, Euchre, Gin Rummy, Hearts, Whist, even "Uno." Today you mostly see Poker, Blackjack, and Solitaire (on our computers), but that's about all. Finding someone who knows how to play the other games is few and far between. The playing of cards goes back centuries, but I find its passing into history an interesting sign of our changing times.
I don't wear a wristwatch anymore and, frankly, don't really miss it. I never really liked wearing one and now consider it more of a status symbol as opposed to something practical for me to wear. When I need to know the time, I can get it from a number of places, such as my computer, cell phone, or in the car. I still manage to make appointments and am considered rather punctual. Other than a scheduled meeting, I am not very cognizant of time during the day other than knowing it is either morning, afternoon or evening. I tend to be more consumed with what I am working on as opposed to watching the clock which I think runs contrary to a lot of people today.
When I was a freshman in High School, I thought the seniors were so wise and cool, particularly those on the football team which I played on. Maybe it was nothing more than the facial hair that gave them the illusion of maturity. More likely though, I think it was their sense of confidence and skills that impressed me. Nonetheless, I couldn't wait to become a senior where I would be empowered with their wisdom. A few years later, when I finally became one, I discovered there was no magical metamorphosis imbuing me with special knowledge, yet I noticed the freshmen were now looking at me oddly in the same way I had done when I was their age. The same was true in college and, as I was to discover, throughout my life. We're all simply dancing as fast as we can and hoping we make the right decisions along the way.
Last week I asked my readers to take a simple quiz regarding American government and history. I wanted to see just how well we knew some of the basics, such as our governing docs and some historical events. Nothing elaborate, I just wanted to take a pulse of our knowledge in general. 134 brave souls took the quiz for which I give my thanks. I didn't want the quiz to be complicated which is why I tried to keep it as simple as possible. I could have asked for such things as age and political party affiliation, but I didn't want to muddy the waters and turn people off.
Whenever I'm asked to discuss the subject of Information Systems in the corporate world, I am inevitably asked, "Where does the programmer fit in?" I think this is an odd question as I see programming as only a small part of the overall puzzle. People are startled when I mention this, particularly programmers, who tend to see themselves as the center of the systems universe. I counter by asking, "What exactly does a programmer do?" After much discussion, we end up with the same answer, "a programmer takes human understandable specifications and converts it to a machine executable program, either by writing and compiling source code or through some interpreter capable of generating the program." This, in turn, leads to an interesting discussion as to what is meant by "requirements" (it seems everyone has their own spin on this). More importantly, it leads to a discussion as to what exactly a system is.
In business, in order to keep people busy, "make-work" projects are devised to keep workers busy until they are needed for serious endeavors. Such projects were commonplace in Franklin Roosevelt's "New Deal" of the 1930's to try and get the country back to work. We are also witnessing it as part of the Obama administration's stimulus program. Here in Florida, the most visible example is the proposed high speed rail project (aka, "Bullet Train") to go between downtown Tampa and the Orlando airport. Over time, it is envisioned it would also connect Orlando with Miami, but for now, Tampa-to-Orlando is the first step.
I have found comedian Jay Leno's "Jay-walking" segments entertaining particularly when he asks simple questions pertaining to the United States. The ignorance regarding how our government is organized and its history is brutally embarrassing. So much so, I wanted to find out for myself just how smart the American public really is when it comes to our history and government. Consequently, I devised the following little quiz to test your knowledge. Please take a moment to answer ten multiple choice questions. 
In last year's midterm elections, the Tea Party flexed its political muscles and changed the face of the U.S. House of Representatives and almost pulled off a stunning upset in the Senate to boot. Now that the 112th Congress has been seated, people are beginning to believe the work of the Tea Partiers is over and they will now go quietly away. Both President Obama and Senate majority leader Harry Reid (D-NV) have made statements suggesting the Tea Party is passé. For example, Reid was recently quoted as saying, "The tea party was born because of the economy... The tea party will disappear as soon as the economy gets better. And the economy's getting better all the time."