Professionalism in the Digital Age

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Aside from the financial incentives for moving from paper to electronic health records (the federal government has pledged to help physicians to make the transition in 2011 with up to $44,000 in extra Medicare fees), the financial disincentives for not doing so (reduced Medicare payments beginning 2016), and the public policy argument that a paperless health information system will lead to lower-cost, higher-quality health care, a primary motivation for physicians to become “meaningful users” of electronic health records should be professionalism, Dr. David Blumenthal, National Coordinator for Health Information Technology, said in a plenary address at the annual meeting of the Society of General Internal Medicine in Minneapolis over the weekend.

“I believe that the proper use of information is a core competency of professionalism. I don’t think professionals can claim to be worthy of the licenses they’re granted and privileges they’re granted unless they know how to find information that’s relevant to their patients and use it in the most sophisticated way that’s available to them,” Dr. Blumenthal told the audience.

“Health information technology is the circulatory system for information in a health care system. In a very short time, it will be as commonly used as the stethoscope, electrocardiogram, and imaging of the chest and abdomen in internal medicine practice, and as routine as the scalpel and suture in surgery.” To be a technically competent medical professional in the 21^st century, he contended, “you have to be able to manage it.”

—Diana Mahoney

What Price Ethics?

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The officers and council members of the Society of General Internal Medicine (SGIM) are facing an ethical dilemma and society president Dr. Nancy Rigotti is asking members for their input. During the opening plenary session at the organization’s annual meeting in Minneapolis this week, Dr. Rigotti reminded the assembled membership that next year’s annual meeting is slated to be held in Phoenix, Arizona. Given the recent passage of that state’s sweeping and controversial immigration bill authorizing police officers to stop suspected illegal immigrants and demand proof of citizenship, ““We are uneasy about holding our annual meeting there,” Dr. Rigotti said.  “I’ve heard from a number of people who don’t think we should go. One of our council members said to me,‘The fact that I won’t be able to go for a morning jog without bringing proof of citizenship makes me very uncomfortable.’”

The dilemma: how to make a statement against the legislation without sacrificing the annual meeting itself or the financial commitment made toward it. “Should we go ahead and hold the meaning as planned and stage a protest while there, or should we cancel the meeting and lose our non-refundable $500,000 deposit?” Dr. Rigotti asked. The financial hit would be particularly hard to swallow considering the organization is currently in the midst of a capital campaign—announced during the same plenary address—to raise nearly the same amount for a down payment on a new property in the DC area to house the SGIM National Office (the nonrenewable lease on the current office space is close to expiration).

Standing up for a cause always comes with a price, Dr. Rigotti acknowledged. The challenge, of course, is deciding how much one is willing to pay.

—Diana Mahoney