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People are constantly targeting every aspect of the physician workflow, from CMS and private payors constantly changing their documentation requirements (which

People are constantly targeting every aspect of the physician workflow, from CMS and private payors constantly changing their documentation requirements (which differ between payors and CMS, and results in hospitals trying to teach their docs to document everything to meet everyone's requirements - which are made intentionally lengthy and obtuse so as to justify denials of payment), quality improvement people and vendors populating the EMR with shit-tons of Alerts! meant to prevent medical errors (but, due to specific medical contexts justifying deviations from the textbook standard, the false positives vastly outweigh true positives, to the point where the alerts as a whole are utterly ignored), etc. It's easy to complain doctors resist (this particular workflow change), which is SO important because it affects PATIENT LIVES (because it's in the healthcare setting, so EVERYTHING DOES) damn entitled doctors. Then recall that every single time a doctor asks a nurse to do something that nurse will say "oh, just enter a communication order." And because your security set up your RFID to only work on a computer where you've already logged in earlier, and you're running around the hospital constantly, those badges aren't worth shit >half the time. It's easy to complain about doctors' resistance to various evolutions of their digital workflow, until you realize that nearly every evolution adds complexity and time-burden to their workload in a way that does not directly improve patient care, but slows down their work, increases complexity (which does adversely impact patient care), and lengthens their workday (because their patient workload isn't reduced in the slightest by this.) I don't know a single doc that doesn't do significant unpaid after-hours work catching up to their digital bullshit; you also would resist non-mission-critical additions to your unpaid workload. It's easy to treat physicians as entitled and resisting "just to resist", rather than understanding that the physician workflow is constantly changing, from every possible angle, and most often for reasons wildly unrelated to the immediate task of "taking care of the patient in front of me". You'd resist under those circumstances, too. There's a reason about half of physicians nationwide (https://www.medscape.com/slideshow/2019-lifestyle-burnout-depression-6011056#1 https://www.medscape.com/slideshow/2019-lifestyle-burnout-de...) are burned out. HALF. That's what happens when your ability to do your job is constantly fucked with. Perhaps you should consider what that means, and how that relates to what you're saying, rather than asserting doctors are just too damn self-important to change.

Scoundreller 7y ago
> There's a reason about half of physicians nationwide (https://www.medscape.com/slideshow/2019-lifestyle-burnout-de... https://www.medscape.com/slideshow/2019-lifestyle-burnout-de...) are burned out. HALF. That's what happens when your ability to do your job is constantly fucked with. Perhaps you should consider what that means, and how that relates to what you're saying, rather than asserting doctors are just too damn self-important to change. Paywalled, but nonetheless, I wonder how that rate compares to other industries. And how much has to do with physicians usually being unable to switch industries without a massive pay cut. Dunno if doctors are particularly too self-important to change than anyone else, but if someone was, I could see that inability itself leading to burnout when things even slightly change around you.
txcwpalpha 7y ago
I'm sympathetic to this, and in other threads I would usually be the first person coming to the defense of doctors and harping on how complex and terrible EMR and other medical software is. But that's not what I'm talking about. I'm not talking about complex software. I'm not talking about instances where doctors are asked to learn an entirely new records management or scheduling system. I'm not talking about the type of systems where you have to interrupt your day with an extra training session on how to navigate the interface. I'm talking about the most basic, bare minimum interactions with security systems that every other person in every other industry has absolutely no issue with, but for some reason doctors refuse to accept. I'm talking about stuff as simple as swiping your ID badge on a reader to gain access to restricted areas. I'm talking about not using work computers to look at porn. I'm talking about basic awareness when it comes to not disclosing sensitive information to a random person in the hallway. Another commenter brought up the number of passwords as a complaint. Again, I'm sympathetic to this. This is why one of my major areas of focus is implementing SSO solutions to cut down on the number of passwords that users have to remember. Except in one instance we had delays rolling out SSO not because the system was complicated to use, but because doctors complained that they didn't like the color of the SSO UI. They insisted it be blue rather than yellow and wanted to scrap the entire project because of it. That's the type of resistance I'm talking about. These aren't difficult or complex things. We are talking about highly educated, highly paid individuals handling highly sensitive information. They should be held to higher standards, not treated like children just because they work long hours. Speaking of working long hours, the second half of your post is just a minor glimpse of the elitism I'm referring to. Are you under the impression that medicine is the only profession in which people experience burnout? Do you think that only doctors have to deal with constantly changing work environments and the never-ending cycle of evolving technology? Every profession deals with these things. Lawyers, accountants, bankers, social workers, police officers, and educators are just examples of professions that have similar or higher burnout rates than doctors. Every single one of these also has to deal with immense amounts of bureaucratic processes, regulations, and inefficient software that is constantly changing and affecting their daily workflow. And yet in my years of consulting I have never met a group that was as egotistically opposed to the use of technology as doctors are. Even investment bankers, which tend to be the most egotistical assholes with an attitude of "I make millions of dollars a day for this company, I don't have to listen to you puny IT people", still don't hold a candle to the willful ludditism of doctor's I've worked with.

Scoundreller 7y ago

> There's a reason about half of physicians nationwide (https://www.medscape.com/slideshow/2019-lifestyle-burnout-de... https://www.medscape.com/slideshow/2019-lifestyle-burnout-de...) are burned out. HALF. That's what happens when your ability to do your job is constantly fucked with. Perhaps you should consider what that means, and how that relates to what you're saying, rather than asserting doctors are just too damn self-important to change. Paywalled, but nonetheless, I wonder how that rate compares to other industries. And how much has to do with physicians usually being unable to switch industries without a massive pay cut. Dunno if doctors are particularly too self-important to change than anyone else, but if someone was, I could see that inability itself leading to burnout when things even slightly change around you.

txcwpalpha 7y ago

I'm sympathetic to this, and in other threads I would usually be the first person coming to the defense of doctors and harping on how complex and terrible EMR and other medical software is. But that's not what I'm talking about. I'm not talking about complex software. I'm not talking about instances where doctors are asked to learn an entirely new records management or scheduling system. I'm not talking about the type of systems where you have to interrupt your day with an extra training session on how to navigate the interface. I'm talking about the most basic, bare minimum interactions with security systems that every other person in every other industry has absolutely no issue with, but for some reason doctors refuse to accept. I'm talking about stuff as simple as swiping your ID badge on a reader to gain access to restricted areas. I'm talking about not using work computers to look at porn. I'm talking about basic awareness when it comes to not disclosing sensitive information to a random person in the hallway. Another commenter brought up the number of passwords as a complaint. Again, I'm sympathetic to this. This is why one of my major areas of focus is implementing SSO solutions to cut down on the number of passwords that users have to remember. Except in one instance we had delays rolling out SSO not because the system was complicated to use, but because doctors complained that they didn't like the color of the SSO UI. They insisted it be blue rather than yellow and wanted to scrap the entire project because of it. That's the type of resistance I'm talking about. These aren't difficult or complex things. We are talking about highly educated, highly paid individuals handling highly sensitive information. They should be held to higher standards, not treated like children just because they work long hours. Speaking of working long hours, the second half of your post is just a minor glimpse of the elitism I'm referring to. Are you under the impression that medicine is the only profession in which people experience burnout? Do you think that only doctors have to deal with constantly changing work environments and the never-ending cycle of evolving technology? Every profession deals with these things. Lawyers, accountants, bankers, social workers, police officers, and educators are just examples of professions that have similar or higher burnout rates than doctors. Every single one of these also has to deal with immense amounts of bureaucratic processes, regulations, and inefficient software that is constantly changing and affecting their daily workflow. And yet in my years of consulting I have never met a group that was as egotistically opposed to the use of technology as doctors are. Even investment bankers, which tend to be the most egotistical assholes with an attitude of "I make millions of dollars a day for this company, I don't have to listen to you puny IT people", still don't hold a candle to the willful ludditism of doctor's I've worked with.