Jon, you helped articulate what I was trying to say much better.
The EMR is being heavily promoted as a gateway to make money, and much less, it seems, because it is intrinsically a good tool. OF COURSE there is nothing wrong in accepting payment for using an EMR, insofar as using the EMR is intrinsically a good thing. And, if the pathway to being paid means "first go through the blue door, then the red door", given that you are going to go through both doors anyway, then well and good. BUT, if the major incentive for installing an EMR was to get paid, when the rules suddenly change, then those that adopted because of the promise of payment feel betrayed and bitter. That sort of bitterness, I think, lies at the heart of some of the abuses you and I reference. There is a feeling of wanting revenge when some mindless third party payor unilaterally decides our services are worth next to nothing or reneges on their promises. It is much less tempting to stretch when one feels he or she is being treated fairly.
Two of my most respected professors tried to instill in me the belief that if a doctor did good by his patients, they in turn would take care of him. Mostly I have found this to be true. I think the focus should remain on the EMR as an intrinsically good thing; a tool that helps us do better medicine. Then the sense of betrayal when promises are inevitably broken might be lessened. We were all idealists when we started our careers. I think it is important to do whatever we can to retain those values.
