Saturday, January 15, 2011


I got the nasty call again. It was from medical records demanding that I sign all my delinquent charts or I would use my admitting privileges. I couldn't believe my luck, I was just starting to go on call. If I could not admit patients, I couldn't take call. Or so I though. The medical records person figured out quick that I was way to happy and then told me that the privileges would be suspended after my call. Dejected, I went to do my records.

It used to be that when you did your medical records, you went into the bowels of the hospital with a big cup op coffee and charts after charts were piled in front of you will all these little sign here stickers. After you signed all the places you would toss the chart into a bin with thud that was Pavlovian kind of like the ding ding of a slot machine. Alas, this is no more.

Now you sit in front of the computer and it shows you the chart. They tempt you right away with this feature that lets you hit one button that says, sign all. Oh, it is so tempting! I couldn't do it. Instead, I went to each document that the computer pulled up. There were hundreds of them. There were things in there that I had never seen, much less agreed to or even knew about. It was like the hospital attorney had hidden every possible thing in the record to make me the fall guy if anything happened. Most of it was in what was called the physician attestation statement. There were pharmaceutical risk documents so if someone got a reaction, the hospital would not be sued, there were restraint orders that I never ordered. I found several on patients that I had never heard of much less been their doc.

I brought this up at the medical executive committee, still trying to convince them to never put me on these committees. When I showed them what happened when you hit the sign all button which all of them had, the room went quiet. There was a definite air of hostility and the flurry of Blackberry activity ceased. A sign that people were really listening. Suddenly, there was a motion to "get the GD F+++ hospital attorney down here state" that got unanimous driving finger seconds and votes. When the attorney came in, the silence was deafening. Finally, there was the standard, some of those forms are JACHO and CMS defaults with the EMR system. No one bought it. I asked who approved the forms to be in the chart. We got the lawyer talk delay, I am not sure but will research it and get back to you.

I motioned that no one sign any charts until this is resolved. Driving finger approval all the way around. Our first doctors strike is on!


SeaSpray said...

Oh Throckmorton - Good for you!!

You had me laughing. I know it is a serious concern ..but your description was funny. :)

I can appreciate the temptation, but I know I'd be more like you with that. For one thing ...that is just too good to be true ..that it should be so easy. And if there is anything that I have learned in life ... mistakes occur all the time. Also, if your name is on it need to know exactly what it is that you are signing ...especially in your profession.

I wonder if your colleagues have any recourse for reviewing charts and removing their signatures? But how would they even know who or when? They'd have to go back to when the new system was implemented. Wow. No wonder it got as quiet as an E F Hutton commercial in the meeting.

I can imagine that stating you all are ticked is an understatement.

I hope it is resolved as quickly as possible.

Being a major Scrubs (sitcom) fan, I couldn't help but to picture the hospital lawyer as the dorky Scrubs -Sacred Heart lawyer covered in his own flop sweat. :)

SeaSpray said...
This comment has been removed by the author.
SeaSpray said...

Deleting last comment as not the place for it. Sorry. :)