Medical Malpractice Insurance in the Age of the ACA Part II

“Twenty years ago, we would have taken care of this with a phone call” said the young internist as I waited with my 90-year-old  mother-in-law for him to work through the lengthy list of questions required at every visit now, due to healthcare reform.  On the one hand, I could understand his frustration with the process.  I recalled my first visit to my own primary care physician, who we fondly refer to as “Crazy Dr. Larry.”  Crazy-BRILLIANT, that is, following Dr. Larry’s implementation of Electronic Medical Record keeping.   Dr. Larry was very frustrated with the new requirements at that first visit.  “You know computers, right?  Can you answer all these questions?  He gave me the laptop and ran to check another patient whose EKG was irregular.  So, I got to try it for myself, working through the lengthy list of questions, and possible replies via drop down menu.  I noted the prompts and other built in checks.  Hmmm, I thought, this might actually be good for Dr. Larry who is multi-tasking and fielding staff interruptions and calls from the hospital during every patient visit.  Back to the young internist, he is not my mother-in-law’s regular physician, and had never seen her before as a patient–he did know that she is a retired physician herself,  and one of his asociate’s most “VIP” of patients.   As he worked through the lengthy list of questions, I noted that he was learning a lot about by mother-in-law’s history, things he probably would not have known had he been using an old paper chart, and reviewed only the last few visits and recent lab work.  Since my first visit after Dr. Larry implemented the new requirements, he has become much more adept at working through the electronic chart and is seeing his patients more promptly.  Certainly, there are improvements that can be made, and much streamlining that can be done.  Bottom line, though, change is hard, but it is not all bad–in fact much about it is an improvement over our old systems.  From a medical malpractice risk management standpoint, the electronic charting will help physicians improve their chart documentation, which is often key in defending a malpractice case.  Incidents of “if it is not in the chart, it cant be proved it was done” will be reduced to nil for physicians diligently completing every field in their electronic  charts.