Electronic Medical Records (EMR) and Pay for Performance (P4P) were never about quality

An article in this weeks American Medical News (March 2008) caught my attention, and thus this commentary is offered. It was entitled "Bush eyes EMRs, P4P to slow Medicare spending". All along, various shills supported by money from their school, the Institute of Medicine (IOM), the Ford Foundation, the Robert Wood Johnston foundation, and members of disreputable medical establishments on both coasts have pushed the lie that EMRs and P4P would somehow help quality. Anyone that looked into this could easily tell that this was nonsense.

First of all, studies on whether this kind of stuff helped quality are mostly negative. There are only a few studies that showed any benefit, a few equivocal studies, and the majority that found these things hurt quality. I argued long and hard about this with many of my well-meaning colleagues. Even when the last AMA president pointed out the harm from EMRs and P4P, they didn't believe me. Well who's laughing now. Bush mentions that EMRs and P4P will slow medicare spending. How will spending large amounts of money on EMRs lower costs? Only by allowing government access to data that they can then use to lower pay. That's it. And the same with P4P. This article treats us like retarded animals and says a portion of current medicare funding (that means money taken out of our payments or a payment cut) will be returned to those who meet unspecified quality indicators.

This means that all of our pay will be cut and a few may get some of the money back - but there is no known standard by which this will occur. What idiots we doctors have become in just a few short years. I blame mostly the ivory-towered pseudo-intellectuals and the doctors who like to feel important by telling the rest of us working stiffs what to do and schmoozing with lying sacks of politicians who run our organizations like the AMA and AAFP. Most of us are too busy to spend time on this stuff, and our trade organizations that were suppposed to help us, have long been taken over by political junkies who thrive on telling others what to do since they have lots of extra time because patients won't see them.

I note that President Bush was "required" by Medicare Modernization Act of 2003 to offer a proposal to cut costs if costs got too high. Where in the US Constitution does it give legislators the power to make the Executive Branch take over a function that is solely that of the legislative branch - bills on revenue and spending? Why haven't the 9 black-robed minions of hell ruled this un-constitutional?

Once again the only way EMR's and P4P could lower costs would be by cutting our pay. And we are being forced to buy the instuments (EMRs) that will allow the government to cut our pay. Shame on us physicians for allowing this! And for the rest of the population, you deserve the contempt of your elected officials for voting for these idiots in the first place, and you deserve the sub-standard medical care and death that awaits you when the best doctors limit or leave their practices. Try and find your mother a good internist in a year when we get more medicare cuts and health care is nationalized. Serves you right.

It was never about quality; it was always about control and paying us less.