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November 15, 2006


Author Affiliations

Letters Section Editor: Robert M. Golub, MD, Senior Editor.

JAMA. 2006;296(19):2315-2316. doi:10.1001/jama.296.19.2315-b

In Reply: As Drs Yackel and Embi point out, some of the problems with physician notes antedated the EMR, although these problems have certainly been amplified by the repetition that EMR engenders. While the remedy for redundant, ineffective EMR notes will indeed be difficult, the assertion of the authors that the problem itself is complex is not necessarily correct. The problem can be simply stated as follows: (1) physicians want to write notes that intelligently describe the clinical situation; (2) physicians want to write notes that are thorough and maximize reimbursement; (3) with the EMR, item number 2 can be done quickly but number 1 cannot; thus, (4) convoluted, duplicative notes are common while thoughtful, logical notes are not.