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Fábregas: Doctors make less eye contact with patients while filling out electronic medical records

About Luis Fábregas
Picture Luis Fábregas 412-320-7998
Medical Editor
Pittsburgh Tribune-Review

Luis Fábregas is an award-winning reporter who specializes in medical and healthcare issues as a member of the Tribune-Review’s investigations team.
Dr. Kevin Garrett, a general surgeon at UPMC Passavant in McCandless

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By Luis Fábregas

Published: Saturday, Feb. 22, 2014, 12:01 a.m.

Dr. Kevin Garrett is the type of surgeon who wants to spend more time with his patients.

You know, the type of doctor who makes eye contact when he's in the exam room and isn't preoccupied by a computer demanding his attention.

“People are complaining that nurses and doctors at the bedside are giving their backs to them,” Garrett said. “I've had older physicians who are now patients who said to me, ‘Do you have the name of an old-fashioned doctor you can send me to?' ”

Garrett, 52, a general surgeon at UPMC Passavant in McCandless, is the new president of the Allegheny County Medical Society. One of his many goals is to work with makers of electronic medical records to cut the time it takes doctors to fill them out. Garrett often finds himself using nights and weekends to complete records because otherwise he'd never talk to his patients.

“Sometimes all I want to do is get an X-ray for my patient and see that X-ray. It should be that easy,” he said.

Yes, it should. Doctors and nurses should have time to care for their patients and not seem like they're attached to a computer monitor and in a perpetual chase to fill out forms.

I was once in the emergency room with one of my kids, and I swear the nurse spent more time in front of the computer screen than in front of her patient. When she asked questions, her eyes rarely left the screen.

Not her choice, and I'm sure not her desire, but one born out of rules imposed by the federal government. Doctors and hospitals will see decreased Medicare reimbursements if they don't adopt electronic medical records by 2015.

Electronic medical records have their benefits, including the ability to find errors and point to harmful drug interactions. But doctors worry that in addition to reducing their face time with patients, some programs are cumbersome to use.

Garrett talked about one of his patients whose electronic record indicated a brain tumor. But the woman hadn't received a CT scan of the brain. Even when the information was removed from the record, it somehow managed to reappear.

He is by no means a pessimist. After we talked, he called me back to emphasize that he's taking on this leadership role, in part, because he's an optimist. He told me that he's impressed with the quality of the students going into the medical profession — a comfort because there is widespread concern about physician shortages.

His only fear is that few of those medical students are choosing specialties such as primary care or general surgery. As one who takes middle-of-the-night calls to do emergency appendectomies and fix hernias, he wonders what would happen to emergency rooms that don't have access to general surgeons.

Garrett said he became a surgeon after studying chemistry at Carnegie Mellon University and considering a career as a pathologist. One of his mentors told him to pick a profession based on “work you don't mind doing and people who you don't mind hanging out with.”

My conversation with Garrett was refreshing because he gave me hope about the future of medicine. Sure, there are problems to be conquered, but leaders like him will no doubt inspire others to push for productive change.




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