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  • Valerie Brooke, MD

Death by a Thousand Cuts

That was the last line of a frustrated email from a physician in our medical group. She was responding to yet another notification from our administration, reminding us to sign up for a 30-minute training session in order to learn how to use a new computer application. It did not matter that the new program had good intent: to show us our billing and production so that we can understand how we are paid in detail. It was the addition of one more thing to our schedules, one more expectation to become competent with yet another computer program, one more thing that has nothing to do with face-to-face patient care. She quipped, “When will I have time to practice what I trained for? To be a physician.”


She made a list of all the programs physicians in our healthcare system are expected to be proficient in, and I have to admit, I was truly shocked at how long the list actually was. EPIC electronic medical system, PACs radiology imaging system, Imprivata opiate prescribing verification system, Dragon dictation system, PowerMic phone dictation application, EDRS death certificate registration system, Outlook calendar and email program, Microsoft teams for ZOOM meetings, Voalte HIPPA compliant texting system, Wellsky therapy scheduling application, OLA for required employee learning assessments, Kronos for timecards and time off requests, Patient Satisfaction System, and now the newest addition, Procare to see our billings in detail.


I totally understand this physician’s frustration. It was the 15th system we needed to learn to use so that we can take care of our patients, communicate with our colleagues, get paid for the services we provide, and review data regarding the care provided. The “death by a thousand cuts” is the feeling that many of us in healthcare struggle with daily. So much time spent on the computer, leaving less time to spend with our patients, less time learning about new medical advances and science that will improve the care we provide. I am technically challenged. I have learned just enough about each of the programs we work with in order to get my job done. I am not a “super-user” of any program or application. I’m positive I could dive in and learn how to be more efficient with each of the programs, but there just isn’t time. And often, just after we learn a new program, things radically change with the next upgrade, or a new system is bought to replace the old one.


I’m not sure I would have gone into medicine if I knew how much time I would be spending at the computer. The ache in the back of my neck is not from taking direct care of my patients and it’s not because my workstation isn’t ergonomically set up. It’s the sheer volume of time, hours and hours every day, looking at a screen and typing on a keyboard. If I had known it was so imbalanced, I may have decided to stay a massage therapist, where all the documentation I did was scrawling a few lines on a piece of paper, to remind myself where the knots were. I envy the old days in medicine I have only heard about, when physicians did just that: a few lines on a piece of paper, in exchange for many more hours at the patient’s bedside.


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