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Health Care Interview

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I have been working as a medical transcriptionist/scribe with my current doctor for over ten years. He has been practicing dermatology for over 30 years and has seen the industry change for the better in some aspects, as well as changed for the worse. I knew he would be a good interviewee as he has seen the industries ups and downs.

Within the Past 5 Years
As stated earlier, Dr. Steven Brenman has been practicing dermatology for over 30 years. When I asked him about letting me interview him for a school paper in regard to the practice of medicine and how it has changed in the past five years, I received an eye roll. His first complaint was the bureaucracy. There are more and more decisions being made by the government rather than citizens. His second complaint was that it is harder to practice without outside interference. For example, when he has a psoriasis patient who needs biologics, it is guaranteed the insurance company will try and deny the prescription because it is too expensive to cover for the patient. Insurance companies want to make sure every other treatment has been used before they will pay for the proper treatment. Dr. Brenman feels the insurance company is questioning the doctor’s opinion and that it all boils down to money. Third, the cost for the practice, as well as patients.

In October 2012, the dermatology office switched to an EMR system. Per the government, the bigger medical practices had to switch to EMR in order to stay in practice. For some practices, this was not a big deal as hospitals such as Kaiser were able to afford the new system, the new equipment, and the extra staff needed. For smaller practices, the cost of the equipment, the new system, and extra workers so the doctors would not have to scribe was more expense than anticipated. There are 16 doctors and each has a medical scribe, each scribe has an iPad to carry in each room, and there were additional medical assistants hired. This all adds up and, as Dr. Brenman stated, is the cost worth all the hassle?

Next 5 years
In the next five years, Dr. Brenman believes there will be more third parties involved in medicine, there were be more unhappy patients as they will not understand the new medical rules and procedures, as well as more costs for the practices and patients. Dr. Brenman has said on more than one occasion that if he did not love his job and the people he takes care of, he would have retired when the EMR system came out due to the frustration and complications it has created.

Overall, Dr. Brenman believes that our health care system does not run smoothly. He believes majority of what should happen looks good on paper, but when the plan is implemented, it does not work as it should. As Dr. Brenman said, “We can only hope for the best, but plan for the worst.”

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