Charles Krauthammer poses a good question in his column this morning (I am quoting the headline on the National Review posting of the column):

If electronic health records are so beneficial, there shouldn’t be a need to impose them on doctors.

After a column on “Why Doctors Quit” (short answer: ObamaCare), Krauthammer heard from  even more physicians who felt their practice of medicine impeded by government regulations, chief among them the requirement of entering patient information in their electronic health records (EHR). He also heard from patients who felt cheated because their doctors spent time entering information on the EHR than talking to them.

Critics of the original column complained that Krauthammer was a Ludddite who resisted the digital age and that the column was a swipe at President Obama, whom they felt was unjustly blamed by Krauthammer.  To the first charge, Krauthammer (who has a medical degree and worked as a psychiatrist before becoming a commentator) responds:

First, I don’t oppose going digital. Properly used, it brings many benefits. The gains, however, are not coming from massive databases attempting to cover and extend to all of medicine, but from far more narrow and tailored adaptations. In radiology, for example, one is dealing with artifacts — X-rays, CT scans, MRIs — that can be easily categorized, digitized, filed, transmitted, and shared in a way impossible in the age of the shadowed X-ray film held up to backlight.

The problem with the EHR, however, is that the pretense of universality leads to information collection that is largely irrelevant to the patient. And, more fundamentally, that the EHR technology, being in its infancy, is hopelessly inefficient. Hospital physicians will tell you endless tales about the wastefulness of the data collection and how the lack of interoperability defeats the very purpose of data sharing.

As for my complaint about President Obama and his fellow liberals: Again, I don’t oppose going electronic. What I oppose is the liberal instinct to impose doing so, giving substance to that old saw that a liberal is someone who doesn’t care what you do, as long as it’s mandatory. Why could they not leave the decision of when and how to go electronic to those who use the technology and can best judge its ripeness and usefulness? Instead, the Obama administration decided arbitrarily six years ago that EHR should be universally in use by 2015. Time being up, doctors who did not conform are now penalized through partial loss of Medicare reimbursement.

Krauthammer’s argument is that, if EHRs are valuable, doctors will begin to use them of their own accord and at a time when the technology is ready to accommodate their needs. He also asks another interesting question: at a time when many, particularly liberals and libertarians, are incensed about the collection of metadata for security purposes, why are not these same people alert to the threat to our privacy posed by EHRs?