Changes

The necessity to use electronic medical records and prove meaningful use measure and quality of care measures add an additional cost, increase administrative burdens and decrease the quality of patient care. The federal mandate to use electronic medical records (EMR) forces physicians to purchase electronic medical record systems, a system with an average cost of $163,765 for a single practice (O’Neill 1). As this is a fixed cost, it is cheaper to share the costs across multiple physicians, a benefit of working at hospitals or large practices. Furthermore, the new system requires “meaningful use” and “quality of care”. Compliance with requires doctors to spend a longer time completing paperwork or risk further reimbursement reductions. Physicians spend 27% of their time in offices seeing patients and 49.2% of time completing EMR paperwork; when in the exam room with patients, doctors spend 52.9% talking or examining patient and 37% of their time doing paperwork (forbes Lee 1). Requiring doctors to complete EMR records while with the patient means doctors spend less time actually talking or examining the patients. The strict requirements and high fixed cost that working with an EMR requires makes running a private practice to be continually less attractive to doctors.

The lack of incentive to operate an independent office must be remedied in the future. The U.S. government must find a way to preserve the entrepreneurial spirit of the health profession. Changing the reimbursement rates to be equal between hospitals and private practices would be a good start. Additionally, improving the requirements of meaningful use and quality of care measures so that they are less difficult to complete would aid private practices in not losing money. The requirements of the Affordable Care Act are not bad in theory, but they must be changed to allow the fostering of entrepreneurship in the health care community.