Writing Is on the Wall for Physicians

In his weekly radio address to the nation Jan. 24, President Bush spoke about one of my favorite topics: modernizing healthcare via computers. But his idea to give the hospital healthcare industry money to get hospitals computerized is a waste of taxpayers’ money.

As a nurse who has worked across the country in several hospitals, I have a better solution: Force doctors to use electronic systems that already exist. Many of the private hospitals in which I have worked have computer systems that are being used by nurses and others but are resisted by physicians.

This resistance has been indulged for far too long. Why? Because of the respect society feels for the medical profession. I recall my own first impression, at age 5, of doctors. To my immigrant parents, “El Doctor Ramos” was the ultimate authority in matters of life. When he handed my mother written notes or prescriptions, she treated them like Moses must have treated God’s written commandments.

But we don’t chisel on rocks anymore. Technological advances have changed virtually every industry, but most doctors still handwrite orders and prescriptions. Fewer than 2% of physicians use electronic computer systems.

The Food and Drug Administration says that “medication errors cause at least one death every day and injure approximately 1.3 million people annually in the United States.” Medication errors could be reduced by 55% if physicians used electronic systems to write orders and prescriptions, according to the Institute for Safe Medication Practices.

I’m privileged to work with amazing physicians, but I’ve also seen the arrogance that explains their resistance to using computers. Scribbling on a handy pad is more convenient than logging on to a computer. But this convenience is costing lives and money.

Change is a difficult thing. It was difficult for the Department of Veterans Affairs, for instance, when it first incorporated a complete electronic system of healthcare. Matthew D. Jeffreys, a psychiatrist at the Audie L. Murphy Hospital in San Antonio, recalled, “When I first heard we were changing over to a computerized medical record, I was terrified. Now I can’t imagine working without them. I can see entire health histories before consulting with my patients.”

Veteran patients are beneficiaries of better judgment calls by doctors who have instant access to their health records. Nurses and pharmacists no longer waste valuable time querying physicians about poor handwriting. Thus, our nation’s vets are much less likely to incur medication errors than other Americans.

So why don’t private healthcare facilities require physicians to use electronic systems the way the VA did? The bottom line is money. Physicians bring patients to hospitals, and hospitals need patients to survive economically. Healthcare administrators hesitate to make demands of physicians that could jeopardize this delicate relationship.

Daily I witness the miracles manifested through the medical community. For this, society owes doctors gratitude and respect. But in today’s computerized era, it should no longer be acceptable for physicians to handwrite life-and-death information.

I hope Bush will reconsider wasting our tax dollars in reinventing the wheel. Electronic systems already exist. We just have to get doctors to use them.

Lillian Gonzalez is a traveling registered nurse working in hospitals in California, Texas, Nevada and Missouri.