There is very little doubt that electronic medical records used correctly are a vital ingredient for advancing medicine through the 21st century. The large problem facing our country is that most small independent, primary-care physician groups will have a problem making payroll for quite a while after they purchase an EMR. In the Northeast, reimbursements have been stagnant. The purchase of the EMR is only the beginning. Billing files for electronic submission are different all over the country; if your billing files are not right, it can take weeks for an out-of-state vendor to correct the problem. Your first month or two, you will be working much slower, seeing fewer patients. The rule of thumb is to take care of the patient first and worry about your practice later. I, for one, think about the emergency procedures on an airplane. When the oxygen mask comes down, make sure you are connected before you try to help someone else, because if you can't function properly, you are no good to yourself or anyone else. The same with a physician office: If you can't pay your staff, buy supplies, pay rent and buy vaccines, you might as well shut your doors, and -- unless you have some cash reserves -- be prepared for the worst.
Clarkstown (N.Y.) Pediatrics
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