After much thought, I have come to the conclusion that the use of an Electronic Health Record is a

disaster. I have not come to this conclusion easily or quickly. It has taken years of increasingly frus-

trating use to arrive at this point.

I now believe that there is one major purpose for the use of an EHR and that is to facilitate govern-

ment intervention into the practice of medicine. Billing is now all about documentation. It has noth-

ing to do with the patient’s problem(s), complexity or time spent. Spend an hour with a patient with

multiple major problems on multiple medications and forget to list at least 5 Review of Systems and

you will not get paid for the work you did if you are audited and you will be. The government has

hired companies to audit physicians and pay them a percent of what roll backs they can make in reim-

bursement. Given that incentive, they will find documentation errors. Physicians who do not use an

EHR by 2017 or who do not document properly will be subject to penalties from Medicare resulting

in decreased reimbursements under a program called Meaningful Use. Who came up with that eu-

phemism?

What is so great about an Electronic Record? The only thing that I can think of is that the patient’s

chart is always available and all labs and procedure reports can be in one place. This is not insignifi-

cant when I remember long ago days when going to clinic and having more than half your patients’

charts was considered a good day. Paper charts were easily lost or misfiled.

What isn’t so great about an Electronic Record? Everything else! It allows the patient records to be

filled with garbage over and over again. All you have to do is cut and paste and you must do this to

make sure your documentation is appropriate. Ask the more than half a million subscribers to An-

them whose records were hacked how they like the system now that their medical histories are open

for all to see. Second only to having your financial data exposed is having your health records out in

the open. Additionally, there is no standardization in the industry. Our current system talks to no

other system without much manipulation and constant oversight. Patient surveys have also shown

that EHR’s have depersonalized medicine by tying the physician to the computer rather than concen-

trating on the patient. But aren’t the alerts or warnings we get helpful in reducing errors? So far that

has not been shown as most physicians ignore the multitude of irrelevant warnings that appear or turn

them off completely.

Ask those who finish rounding in the hospital how much longer it now takes to write notes so they

can document and justify their billing. Of course it doesn’t help that our hospital’s system is different

and basically incompatible with the system at the MFA. But worry not as we are purchasing another

incompatible system that will also take additional hours of unpaid training to master.

Bring back paper! I promise I will write clearer and neater. I promise I won’t keep charts in my

office and will make sure they are refiled. I will promise anything to get rid of this monster we have

created that has done much to erode patient care, quality of care and relationships with patients. But

it probably won’t matter to at least 13 million Americans who will lose their Health Care when Presi-

dent Ted Cruz abolishes Obamacare. Ironically, after comparing Obamacare defunding critics to

Nazi appeasers guess who just signed up? Neville Cruz Chamberlain himself. I guess he believes in

the old adage “do as I say not as I do.”

April 2015 Volume 19, Issue 4

GW Medicine Notes

A Monthly Publication of the GW Department of Medicine

From the Chairman

Dr. Charlie Lee, PGY 2 (above)

Dr. Laura Perry, Chief Resident (Left)

Dr. Samah Nassereddine PGY2 (above)

(continued on pg. 3)

Alan G. Wasserman, M.D.

Resident Presentations:

SGIM Regional Photos

SAVE THE DATE

END-OF-THE-YEAR PARTY

FRIDAY, JUNE 12, 2015

Department of Medicine April 2015 Grand Rounds

Medicine Team Contacts

Page 2 GW Medicine Notes

WHITE TEAM (202) 715-5669 YELLOW TEAM (202) 715-6041 GREEN TEAM (202) 715-6062 RED TEAM (202) 715-6039 BLUE TEAM (202) 715-6156 SILVER TEAM (202) 715-6040 PURPLE TEAM (202) 715-6042 GOLD TEAM (202) 715-6044

ADMITTING RESIDENT 741-0161 pager

Resident Lecture Series April 2015 Noon Conference

Apr 1 GME Core Lecture Apr 2 Grand Rounds Apr 3 “Myocarditis”- Dr. Gurpreet Sodhi Apr 6 “Transfusion Reactions”- Dr. Tony Finianos Apr 7 Journal Club Apr 8 “Physiology of Aging and Common Geriatric Complaints” - Dr. Christina Prather Apr 9 Grand Rounds Apr 10 Chairman’s Rounds Apr 13 “Vascular Amputations/Regeneration” Dr. Philip Marion Apr 14 “Reinvigorating Primary Care”- Dr. Nupur Mehta Apr 15 “Positive ANA/SLE”- Dr. Victoria Shanmugam Apr 16 Grand Rounds Apr 17 “Syphilis”- Dr. Marc Siegel Apr 20 TBD Apr 21 Clinicopathology Conference – Drs. Jason Gendell and Aung Myint Apr 22 “Oral Anticoagulants”- Dr. Kavita Natrajan Apr 23 Grand Rounds Apr 24 Chairman’s Rounds Apr 27 “Kidney Stones”- Dr. Samir Patel Apr 28 TBD Apr 29 “Weight Management”- Dr. Ginger Winston Apr 30 Grand Rounds

Apr 2 “Dermatologic Oncology”

Brandon Mitchell, MD

Assistant Clinical Professor of Dermatology

Department of Dermatology

GW Medical Faculty Associates

Apr 9 “Limb Salvage and Preservation”

Benjamin Wood, MD

Assistant Professor, Plastic & Reconstructive Surgery

Department of Surgery

GW Medical Faculty Associates

Apr 16 Tamagna Lecture: “Eighth Joint National Committee

(JNC 8)”

Jackson Wright Jr, MD, PhD

Professor of Medicine

Case Western Reserve University

Director, Clinical Hypertension Program

Program Director, William T Dahms Clinical Research Unit

University Hospitals Case Medical Center

Cleveland, Ohio

Apr 23 “Chronic Lymphocytic Leukemia”

Imad Tabbara, MD

Professor of Medicine

Director, Blood and Bone Marrow Transplant Program

Director, Fellowship Training

Division of Hematology and Oncology

Department of Medicine

GW Medical Faculty Associates

Apr 30 Dornfeld Lecture – “Stem Cell Therapy”

Armand Keating, MD, FRCP

Director, Cell Therapy Program and Philip S. Orsino Facility for Cell

Therapy, Princess Margaret Hospital/Ontario Cancer Institute;

Professor of Medicine,

Professor, Institute of Biomaterials and Biomedical Engineering,

Director, Division of Hematology

Epstein Chair in Cell Therapy and Transplantation,

University of Toronto

Cardiology Grand Rounds 5:00 PM, Ross Hall, Room # 104

Apr 1 Mortality & Morbidity Conference Apr 8 Kelli Metzger, MS, RD, LDN, CDE Dietitian Department of Medicine GW Medical Faculty Associates The Mediterranean Diet Apr 15 Allen Solomon, MD Professor of Medicine Division of Cardiology Department of Medicine GW Medical Faculty Associates Atrial Fibrillation and Cognitive Decline Apr 22 TBA Apr 29 Juliet Lee, MD

Assistant Professor of Surgery

Department of Surgery

GW Medical Faculty Associates

CV Effects of Bariatric Surgery

The George Washington University Medical Center (GWUMC) is accredited by

the Accreditation Council for Continuing Medical Education (ACCME) to

sponsor continuing medical education for physicians. GWUMC designates this continuing medical education activity on an hour-for-hour basis in Category I of

the Physician’s Recognition Award of the American Medical Association.

(AMA).

GW Medicine Notes Page 3

2015

Internal Medicine Match

CATEGORICAL Name Medical School Alexander Aldrich Wake Forest School of Medicine of Wake Forest Baptist Medical Center Brandon Anderson Medical University of South Carolina College of Medicine Lauren Choi Drexel University College of Medicine Tanuka Datta Wayne State University School of Medicine Kusha Davar George Washington University School of Medicine and Health Sciences Vincent de Chavez University at Buffalo State University of New York School of Medicine Viktoria Elkis George Washington University School of Medicine and Health Sciences Michael Elliott University of New Mexico School of Medicine Charles Fischer Sidney Kimmel Medical College at Thomas Jefferson University Tushina Jain New York University School of Medicine Caitlin Klimavicz Virginia Commonwealth University School of Medicine Stanley Liu Virginia Commonwealth University School of Medicine Sivateja Mandava Oakland University William Beaumont School of Medicine Kristen Millado Michigan State University College of Human Medicine Caitlin Mingey Sidney Kimmel Medical College at Thomas Jefferson University Ivan Pena Rutgers New Jersey Medical School Gregory Piech Drexel University College of Medicine Hind Rafei American University of Beirut Faculty of Medicine Talia Salkeld Garcia University of Miami Leonard M. Miller School of Medicine Christina Sensabaugh Tulane University School of Medicine Nardos Temesgen Wright State University Boonshoft School of Medicine Stephen Testa Drexel University College of Medicine Matthew Tick Kansas City University of Medicine and Biosciences John Glenn Tiu Drexel University College of Medicine Sarah Tran Albany Medical College SUPPORTED INTERNATIONAL GRADUATES– CATEGORICAL Name Medical School Qusai Al Saleh University of Dammam College of Medicine Hani Alhamoud Kuwait University Faculty of Medicine Alia Khoja University of Dammam College of Medicine

PRIMARY CARE

Name Medical School Samantha Blum Chicago Medical School at Rosalind Franklin University of Medicine Celia Mouyal University of Maryland School of Medicine Sripooja Satya University of Texas Medical School at Houston Jennifer Schwenk University of Miami Leonard M. Miller School of Medicine Anokhi Shah Drexel University College of Medicine

PRELIMINARY

Name Medical School Sumeet Gupta University of Virginia School of Medicine In Kim New York University School of Medicine Cathy Meade University of Maryland School of Medicine Ankur Patel Virginia Commonwealth University School of Medicine Priya Patel Rutgers New Jersey Medical School Jill Remick George Washington University School of Medicine and Health Sciences Sahil Sekhon Case Western Reserve University School of Medicine Loulwah Mukharesh King Abdulaziz University College of Medicine and Allied Sciences Mithilesh Siddu Andhra Medical College (Neurology Prelim)

Dr. Sheliza Lalani, PGY3 Dr. Talal Alzahrani, PGY2

Frontiers of Medicine

The next Frontiers in Medicine panel discussion is scheduled for Wednesday, April 29, at GW's Jack Morton Auditorium, 805 21st Street, NW, beginning with a reception at 6:15pm. Titled "Innovations in Kidney Disease Research and Transplants” our medical experts will discuss the latest findings in renal disease research and new de-velopments in kidney transplantation Our panelists include:

Keith Melancon, MD – Chief of Transplant Surgery and Profes-

sor of Surgery

Muralidharan Jagadeesan, MD, FACP, FASN – Director of

Transplant Medicine and Associate Professor of Medicine Moderator: Anton Sidawy, MD, MPH, FACS, Lewis B. Saltz, Chair of Surgery and Professor

RSVP Required at go.gwu.edu/frontiersinmedicine

Chairman’s Rounds GWU Hospital Auditorium, 12:00 Noon

All Faculty Invited to Attend

Apr 10 Dr. Ashley Styczynski Dr. Steven Quinn Apr 24 Dr. Georges Al-Helou Dr. Wadha Al-Jaser

… (cont. from pg.1 ) Resident Presentations:

SGIM Regional Photos

The George Washington University Medical Faculty Associates

Department of Medicine, Suite 8-416

2150 Pennsylvania Avenue, NW

GW Medicine Notes Page 4

See you next month! The Editor

Kudos…to Dr. Mohammed Fadlalla, PGY3, as he received praise from

a third year medical student, “He has this gentle, warm, comforting bed-

side manner that he carries through to when he steps into the educator

role. It makes learning enjoyable and non-intimidating.”

Kudos… to Dr. Christine Teal and Dr. Robert Siegel, as they received

a letter of praise from a patient, “My mom is convinced she couldn’t be in

better hands.”

Kudos… to Dr. Christina Prather, Geriatrics, on receiving a letter of

praise from a patient, “… the amount of genuine empathy and kindness

she showed my mother and our entire family was beyond anything I ex-

pected… to say she went above and beyond what was required of her is an

understatement.”

Congratulations… to Dr. Ashte Collins, Nephrology, on the newest

addition to his family. His baby girl, Alyssa Tran Collins, was born on

3/14/15.

Congratulations… to Dr. Meera Mehta, MS4, on winning 1st place for

her oral presentation in the Clinical Vignette category at the SGIM mid-

Atlantic regional meeting. Her topic was, “The needle in the diagnostic

haystack: Isolated neurosarcoidosis presenting as meningitis in a young,

healthy patient.” Her co-authors were Dr. Jessica Davis, PGY3, and Dr.

James Gehring. Great work!

Rheumatology Academic Conference Schedule April 2015

ACC Building 6B-411B (8:00 am - 9:00 am)

Ross Hall: Room 201C (1:00 pm– 3:00 pm) Questions? Call (202) 741-2488

Apr 2: “Transition from pediatric to adult health care” Dr. Patience White, MD Apr 2: Rheumatology Divisional meeting Apr 9 : Journal Club Dr. J. Miller Apr 9: Didactic Sessions 1:00 - 3:30 p.m., GW Hospital, 6th floor Apr 16: Intra-City Rheumatology Grand Rounds NOTE LOCATION: NIH NOTE TIME: 7:30 AM Apr 16: Didactic Sessions 1:00 - 3:30 p.m., GW Hospital, 6th floor Apr 23: Radiology Conference Dr. Kathleen Brindle, Associate Professor of Radiology Chief, Musculoskeletal Radiology Location: GW Hospital, Radiology Conference Room Apr 23: Didactic Sessions 1:00 - 3:30 p.m., GW Hospital, 6th floor Apr 30: “Small Fiber Neuropathy” Dr. Ehlam Bayat Apr 30: Didactic Sessions 1:00 - 3:30 p.m., GW Hospital, 6th floor

Kudos & Congratulations