This is all so disheartening to me.
Nowhere in any of this discussion is the fact that insurance companies and the government limit what we can charge, and that limiting charges supposedly builds in overhead costs.
Overhead costs -- at least in Medicare -- include things like rent and heat and lights, but also bandages, dressing material, office help, and IT costs. The "overhead" formulas were determined before any of us had computers, and there has never been (at least not to me) ant adjustment for the cost of EHR's. Increasing costs can not be passed on to the payers, and as a result, our only surivial tactic is to see more patients per day -- degrading the quality of care.
I do not believe that ANYONE can make the claim that EHR's have increased eiher the quality or availability of medical care, or reduced its cost.
In the beginning, AC was a very cost effective way to explore and develop EHR's, and the early versions were promising. As they got loaded down with more bells and whlstles, and became tools of the administrative class, not the medical professional class, they became sluggish, burdensom and expensive. There is no way that AC can compete with the monster corporate EHR's like EPIC, and so the destruction of independent practice willl be complete.
I am sad to be leaving all my patients and going out to pasture -- but at the same time, it will be a great relief.
