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Comment by jraines | Hacker News Reader

All of this rings true from what I've heard my dad, a GP, complain about for years. It's hard for him to watch other doctors game the system to increase their earnings -- not only seeing more patients with unaccountably short sessions, but also up-coding their maladies and ordering unnecessary tests.

In addition to the pressure of seeing more patients per day, they have all this new administrative bullshit (ironically in the name of efficiency) preventing them from doing so. For example, doing charts went from dictation, to data entry in absurdly bad (understatement) EMR software on cheap, outdated hardware that they weren't properly trained to use. And oh yeah, you can have pay withheld if you fall behind on that, too.

It's just sad, and many older doctors don't even recommend the profession to young people at this point.

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My doctors usually spend less than 5 minutes talking to me and 10 minutes hunting and pecking at the computer. Some offices will have other staff do much of the data entry, but it doesn't seem to result in the doctor any spending more time with me.

Precisely we just created an start-up with a product that helps doctors making the EHR much faster and intuitively so they can focus on the patients.

I believe you, but when I worked in a medical office in 1993 vendors were saying that exact same thing.

I know, I hope my Background as MD and CS plus the idea we had will make it different. We are working on something similar to an IDE :)

Break a leg :-)

And whatever you do, just don't let anyone deploy it on some overloaded Citrix server.

Congratulations in advance for when EPIC buys your company and then ruins your product.

Epic doesn't acquire.

You sound like me and this sounds like software I created more than a decade ago. Good luck. It is an incredibly difficult sale (yes, I am a little bitter :))

Cool, me too :) would be interested to hear more on what you are working on if you are in the city. (SF)

Me too and I am near SF. Would also be interested in talking

The hospital system my dad works for just got all the doctors scribes to take the data entry burden off of them.

You could try looking for Direct Primary Care, another growing movement among doctors in reaction to how messed up the system is.

I wrote a bit about it recently:

Http://micheleincalifornia.blogspot.com/2015/12/how-to-fix-americas-financial.html

Similar story in the UK. My aunt, who works for the NHS (not a GP), has cried in the toilets a few times because she is forced to use bad software to the point of utter frustration, and she is not of the computer generation. There are ~10 people in her team in a simular situation. They should just have a dedicated person doing data entry in to the computer system.

Not having dictation is just dumb. Voice rec is quite capable these days and the doctor's time is too valuable to waste on their typing speed.

One note though, the PC never really has to be any good because most of the EMR crap is accessed over Citrix... To make IT's life easier (in theory) and avoid having the need for fancy PCs on the wards.

Hell, I'm only in my second year of med school in the US, and I wouldn't recommend young people go into this profession.

I'm in the last year and I would totally do it again. It's true college it's abusive(http://www.kevinmd.com/blog/2016/01/physicians-arent-burned-...), but I find it amazing as a career.

(MD here...)

With all due respect, wait until you have been in the profession for at least one decade. Then, I'd like to hear your opinion again.

I'm sure the work is super hard, and I will change my opinion, everybody said that to me, but at least academically, I found it amazing. :)

>>It's hard for him to watch other doctors game the system to increase their earnings

Make no mistakes this isn't just restricted to the US. This is quite common in India too.

>>not only seeing more patients with unaccountably short sessions, but also up-coding their maladies and ordering unnecessary tests.

In India there practices are almost in the fraud territory. Start from doctors having small testing labs in their clinics. Where they order unnecessary test for patients they don't need. Almost every clinic has a neighboring pharmacy, that sells medicines of brands only the doctor next to it prescribes. You won't be able to buy that medicine anywhere else, plus the doctor makes commission in the medicine sold in the pharmacy. Prolonging treatments to maximize per consultation fees is extremely common.

Its very common for hospitals to indulge in advising patients with either incorrect treatments or prolonging treatments. Pointless tests, doctors cooking up stories to scare patients to spend more at hospitals is all common.

>>It's just sad, and many older doctors don't even recommend the profession to young people at this point.

I talked to many doctors(friends, relatives and acquaintances) actually many feel cheated opting to chose a career in medicine. They are told they are very smart people, and all. Told they are super smart hence they deserve to go to medical college. Hence they expect to be paid proportionally. Most watch their friends in engineering, who they think have it(apparently, that's how they perceive it) a lot easier. While they spend a lot of studying, piling up a good deal of student debt, plus on a average making the same money at the end anyway. Except that every thing in life happens decades later.

They look at engineers, especially programmers as people who have a lot of opportunity to switch streams, learn and move on to new stuff, work at big companies, start companies. Especially programmers who are good investors come across as people who made far more sensible career decisions.

Doctos at the end of the day are humans, and are driven by peer financial pressures.

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