Why doctors hate their computers (2018)

Paper vs Digital Care Experience

• Several commenters praise “quaint” paper-only practices as more personal and less rushed; they feel computers make visits transactional and network-driven.
• Others argue refusing digital tools is a red flag, especially in fields like dentistry where techniques, materials, and imaging improved dramatically.
• Some note that the real issue isn’t paper vs digital but how much time the system forces doctors to spend on screens instead of patients.

Electronic Records: Benefits and Frustrations

• Many report EMRs are clunky, brittle systems optimized for forms, drop-downs, and billing codes, not clinical thinking.
• Positive cases exist: integrated systems (e.g. large HMOs) make record transfer, labs, meds, and messaging smooth, especially for complex patients.
• Some doctors and dentists “hack” or script Epic-like systems to automate workflows, highlighting unmet UX needs.

Workflow, Billing, and Misaligned Incentives

• Multiple physicians say EMRs’ primary purpose is to generate billable codes and satisfy compliance, with decision support “tacked on.”
• Purchasers are executives, not front-line users; examples include absurd UI elements (“order birthday cake” buttons) prioritized over core tasks.
• Commenters tie this to broader trends: doctors becoming cogs in hospital/PE/insurer-run systems, and software sold by promising compliance, not usability.

Privacy, Security, and Regulation

• Some practices deliberately stay non-digital to avoid HIPAA burdens; others note paper reduces the blast radius of breaches.
• Others counter that electronic prescribing and structured data can also prevent errors that paper creates.
• Debate over whether HIPAA security is “good enough,” with emphasis on BAAs, liability chains, and fines.

Doctor Computer Skills vs Software Quality

• Stories of physicians unable to export images or lock workstations prompt arguments: is this a skills problem, or bad enterprise UX and policies?
• Some insist basic computer literacy and touch typing should be standard; others say doctor time is too valuable, and scribes or better tools are preferable.
• Medical software and device engineers describe a “90s-era” ecosystem: underpaid devs, heavy regulation, archaic tooling, and documentation work crowding out UX improvements.

AI, Voice, and Transcription

• Ambient “listen-and-summarize” tools and voice dictation are already in use; some clinicians love the reduced typing.
• Others are alarmed by always-on recording and third-party/cloud involvement, seeing major privacy risks even if “HIPAA compliant.”

Digitization, Data, and Research

• One side claims digitization doesn’t change cure rates much; others argue that large, longitudinal digital datasets could unlock prevention—if data quality weren’t so poor.
• Attempts to mine EHRs at scale often fail due to inconsistent, low-quality documentation, despite the theoretical promise.