The Future of Medicine

Posted By: Mark G. Bearman, M.D.       Date: February 10, 2012

Bob Dylan once sang "the times, they are a changing..."  For the practice of medicine, these words have never been truer.  I would like to share my thoughts regarding the challenges facing our profession and especially issues directly related to eye care and patient care at VisionFirst Eye Centers.

When I first began practicing (in West Palm Beach, FL) in the late 1980's our practice needed very little management expertise for sophisticated information systems.  It seemed the practice was on somewhat of an auto-pilot.  We saw patients, they paid for their care and were reimbursed by their insurance company.  Ahhh, the good old days.  Well those days are certainly gone forever.  At VisionFirst we now employ 4 full time insurance clerks to help manage our claims.  In the last few years, Medicare has issued summons that requires physicians to convert their paper charts into electronic medical records.  To date, we have had to spend several hundred thousand dollars converting our charts into these electronic records.  Unfortunately there is a very significant "learning curve" associated with this as well as training for our personnel.  To date, this has had the unfortunate side effect of slowing our office visits due to the extensive background information and historical data that must be put in the computer for each patient.  Hopefully as we become more proficient with our new computers patient wait times and evaluation times will speed.  Also it is mandated that each patient either receive a copy of their examination at the end of their visit, or have this information sent to their email address.  This helps with the portability of patient records but requires a great deal of time and paper and sometimes I begin to think that perhaps electronic medical records and the "paperless office" is just a myth. 

I believe most any physician dealing with these national mandates (i.e. Medicare) is finding that productivity stalls at least for a while until the kinks can be defined and worked out.  Unfortunately this sometimes translates into productivity lags and increased expenses for physician offices.  At VisionFirst we've had to limit our number of appointments so that we can finish in a somewhat timely fashion.  In any regard, we are going to continue to perfect our technology systems and provide the highest quality of care to our patients.  Again from the Bob Dylan song book "...the first one's now will later be last..."  seems to be a warning for those practices who do not change with the times. 

MGBMD