The Doctors Office Is Closed
After three years, one enterprising primary care doctor pulled the plug on an online system that was mostly ignored by his patients. The story is illuminating on a number of levels.
Dr Ben Brewer’s experience was covered in the WSJ article A Primary Care Doc Builds an Electronic Office, and Nobody Comes by Jacob Goldstein, which is accompanied by a number of insightful comments. On the surface it seems like this was a sure winner, an appropriate use of technology. The advantages for the patient are very compelling: No travel, no wait, and no exposure to sick people, no hassles, and no lectures on changing bad habits. Probably the main advantage for the doctor is absolute control over his time.
The costs for the system, particularly the transaction fees, seem incredibly high for today, but may have seemed reasonable when he committed to the system three years ago. The patient cost for the ‘eOfficeVisit’ seems very reasonable given the advantages already mentioned. However (always one of these) some patients complained about it not being covered by the co-payment, which just points out the monopoly mentality of the carriers and how the premium payers have expanded the concept of insurance to a form of entitlement. The lack of personal responsibility is also interesting.
I doubt that the disuse of the system was an age thing. From what I see, most oldsters are not only familiar and comfortable with using computers, but also rely on it to eliminate unwarranted travel and being able to stay in touch with friends and family. I also doubt it was a cost thing, which certainly would be exposed to the Cheap Revolution described by Daniel Lyons and Rich Karlgaard.
I suspect that Dr Brewer’s experience with an attempt like this is not unique, which suggests to me that any solution to the medical industry’s problems will not be based on technology. If the customers/patients don’t use such a system, then how can the government hope to get a national EMR system accepted?
Tags: e-medicine