What scares doctors about technology

What scares doctors about technology

Summary: You can easily see the fear. You're no longer a sole practitioner, with your own office and your own credibility. You're an employee. The face to your patients may be CEO Charles Willey.


Esse Health logoI think I know what most frightens physicians about technology.

It's the fear of becoming part of a roll-up, like Esse Health, profiled recently by the St. Louis Post-Dispatch.

On the surface Esse is simply a collection of doctors' offices. But when new CEO Mike Castellano talks about it, he's describing something that sounds a lot more like McDonald's:

Mike Castellano, the company's new chief executive, said he wants to promote Esse's name throughout the community and he hopes to create a brand that links the name to the practice's philosophy on medicine.

"The organization, in my view, has matured to a point where it is a large small company on the verge of becoming a small large company," said Castellano, who is a certified public accountant by trade.

essence-logo.gifThe key to all this is technology. Esse uses computers and networks not only to automate billing, but to actually deliver better care, with simple things like e-mailing blood sugar and blood pressure results to patients.

Purkinje logoIn fact, technology is now a profit center. The company's original EMR platform, called Wellinx, merged with a Canadian company in 2005 to create Purkinje, which sells practice automation systems at prices as low as $399 per month.

Because it makes effective use of technology, Esse is also able to run its own Medicare Advantage program, which it calls Essence. This brings in patients and cash flow. Careful management is needed to make a profit in this kind of business, but if it can be done it gives a practice a big advantage.

You can easily see the fear. You're no longer a sole practitioner, with your own office and your own credibility. You're an employee. The face to your patients may be CEO Charles Willey.

And when hard decisions are being made, whether financial or medical decisions, you're no longer the one making them. Would you like fries with that heart screening?

The answer, if you're afraid this is going to happen to you, is to beat the roll-ups to the punch. Do your own automation, and do it right. Easier said than done I know, but what choice do you have, really?

Topics: CXO, Health

Kick off your day with ZDNet's daily email newsletter. It's the freshest tech news and opinion, served hot. Get it.


Log in or register to join the discussion
  • Process Uniformity

    Most companies that serve the public such as McDonald's strive for process uniformity. Such uniformity ensures consistent outcomes across multiple client encounters and geograhpic locations.

    Healthcare services delivery is still very much a "cottage industry" in many ways, with each provider delivering care using their own set of care processes. Employing IT offers the possibility of delivering care in a more standardized, consistent manner, based on care protocols that have been researched and found to be effective. Further, IT offers the opportunity for multiple healthcare providers to collaborate in the delivery of care and to share information about a specific patient.

    If standardized care results in better outcomes then we should probably encourage it. If not, then perhaps doctors should be scared.

    Michael Martineau
    eHealth Practice Lead
    Branham Group Inc.
    • Is medicine art or science?

      That's the question your comment raises. I think most doctors feel there is an art, a feel to what they do, which is difficult to measure by hard-and-fast numbers.

      The McDonald's approach to medicine does assure everyone gets the same care, and it protects everyone in the chain from lawsuits, but it doesn't always meet the needs of patients.

      Of course, maybe I watch "House" too much. <g>
  • Lawyers have more to fear

    When I started a string of Urgent Care Medical Centers in the Seattle area we made use of standard legal forms you can get at any office supply store. The lawyers we did hire would only review documents "for form" anyway.

    With the Internet, the profession most impacted by search engine technology are the lawyers. Everyone is presumed to know the law and it becomes less and less foolish to represent your self given Web 2.0. You do of course need a clerk who understands the system in your jurisdiction.

    This isn't the case with physicians. There are a variety of reasons. But primarily there is this notion that the mind can fool you into being sick. It takes a human independent of yourself to determine when that is the case. The same is true for the real estate business. The owner often can not sell because they are not thinking about a real estate property but rather a home where they might have raised a family.

    But undoubtedly, the world does not need more 180,000 dollar physicians. The world wants more physicians in the 80,000 range.

    For those who got into medicine because they were interested in it, I do not think there is any problem. But for those that got into it because of the income potential there may be.

    Physicians have long been influenced by medical equipment and drug manufacturers who offer "incentives" of questionable legality when it comes to Medicare and Medicaid. Fraud in these programs is often related to unreported income in that form.

    Now this next paragraph is important.

    Physicians are being overly influenced by technology firms. It has always been so but recently a law was passed allowing a technology firm to give an entire laptop computer away with software to physicians for evaluations of medical records software. That is several thousands of dollars and a legal bribe in a purely private practice. If unreported - it is fraud when the practice does Medicare and Medicaid.

    What is worse is that the US government already provides systems for medical records. The Vista system recently won an award for innovation from Harvard. There is also a Vista Office and the entire bunch is open source.

    What we have here is a multi national corporation that wishes to get into a market already served by government. Fortunately, The US government passed a second law preventing those physican practices already operating Vista from accepting free Microsoft laptops loaded with closed source software that does the same things.

    I now call for a tax on charities such as the Bill and Melinda Gates foundation.
    • Thanks for writing, but I have a question

      When you mention Vista Office, I assume you mean VistA Office, which is based on the Veterans Administration software VistA, as opposed to the Microsoft Windows Vista operating system?

      I want everyone else to understand which VistA is which.

      The VA version of VistA was not open source, by the way, but completely public domain. The current OpenVistA project is an open source version of the code. Medsphere, which launched the OpenVistA project, is now selling a proprietary version of the software, which includes extensive payment and billing modules.