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Health IT sending older physicians over the retirement cliff?

File this one under “heard on the health IT street”: At the American Health Information Management Association convention last week in Orlando, FL, representatives from the central Florida and combined Minnesota-North Dakota health IT regional extension centers (RECs) gave presentations on their efforts to get solo docs and small group practices up and running with electronic health records (EHRs).

At other conferences, we’d been hearing that physicians over a certain age (some experts theorize it’s 40; others, 45; and still others, 50) would play out the string until meaningful use became mandatory, using their same old paper workflows. Maybe they would stick around a couple years, then close up shop instead of making the transition to an EHR system.

It is unthinkable to technology advocates that computerizing the nation’s health care records could actually worsen the system, but those with boots on the ground are seeing this unintended consequence of the health IT buildup as a very real possibility — despite the incentive of nearly $50,000 per solo physician for purchasing and EHR system.

The REC reps — who speak daily with practicing physicians who are planning to implement EHR systems — confirmed it’s starting to happen. Right now there’s a shortage of family physicians. With the baby-boomer generation aging and its need for medical attention increasing, and the following generations being less populous, the shortage will only get worse. Throw in a certain number of docs quitting over mandatory EHRs, and the system could break.

Many physicians are doing the math on retiring early, said Karen van Caulil from the Central Florida HIT Initiative at the University of Central Florida College of Medicine REC during a presentation offering strategies for leveraging REC services. It doesn’t work out in favor of EHR implementation every time. In fact, for some physicians it’s a “really big barrier” to staying in business past 2015, when Medicare penalties kick in for doctors still using paper, she said.

“When you look at the expense that they will have to incur in their practices to get from paper to electronic [records],” van Caulil said, “and then look at when the penalties start coming in — 1% a year, year after year — sometimes it makes sense for them to take a couple of years of reduced payments from government-paid clients.”

And then retire. Or perhaps stop seeing Medicare and Medicaid patients. That strategy is very concerning, considering it will worsen an already acute physician shortage, van Caulil said. Is there any way health information managers and their IT staff colleagues can talk their physicians contemplating retirement back from the edge of the cliff? Put them in contact with their local REC, which is designed to ease the transition, suggested co-presenter Shirley Eichenwald Maki, from the REC and Assistance Center for Minnesota and North Dakota.

Read more of their tips on leveraging REC resources.

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