Sam R. Riley follows me around the Internet, including to the comments of The Last Psychiatrist, defending Practice Fusion and attacking me. I assume from the contents of his comments that he would like to draw more attention to me and my opinions about Practice Fusion.

Very well. However, it is good manners to move unrelated discussion to your own website, and so I have done this.

My comment (excluding extraneous details):

…
My ire derives from that this technotronic bamboozling continues be abused to con vulnerable _doctors_ (and by proxy, their patients) into poor decisions with dire future ethical hazards. For example: http://www.practicefusion.com.

Practice Fusions’s “business plan” is to provide a “free EMR” which will store all your patient’s billing and medical information and then sell that information to marketers for advertising. In exchange, the doctor gets “$45,000 free money” from Medicare, plus “free EMR software service.”

Now, if you had to fill out a grubby paper forms in a dingy office as advertised on TV so that your doctor could sell your demographics to some aggressive “outside agency” to “pay his bills,” that would be outrageous.

And yet, that is exactly what is happening here with Practice Fusion and —I promise you— other “social media” web 2.0 applications which are coming. Because they use a flashy website and not paper forms, and because they advertise online rather on television, we don’t make the ethical connection.

It’s funny: people think it’s the patients who need to be protected. Oh no. No no no. I can assure you, it’s the _doctors_ who need protecting, because patients don’t make decisions —doctors do— and doctors are going broke because many medical insurers are bankrupt and continue to simply miss minimum payments with a barrage of lame excuses and evasion.

No no, I don’t think “other” people entrusted to me are “retarded.” I think that the human condition _universally_ is “retarded,” and I include both myself, doctors, and patients as humans. That’s what tortures me.

Sam Riley’s response:

My Yates,

I was very surprised when reading your comments, particularly at your hostile tone, as I am a Practice Fusion user and have been for some time now. From my experience the product and it’s functionality have been top notch, and the support from their team has been a class act. The e-prescribing feature and lab integration features are excellent – and every time I log into the product there seems to be more functionality available to me. In the past I used to use eclinicalworks at a hospital I worked at and it was a terribly unfriendly application. The screens were hostile and non-intuitive and the application was always freezing and slowing down our interaction with patients.

I was concerned about data sales when registering for Practice Fusion and discussed this with my account manager, as well as actually read the user agreement when registering – and made sure that they do not sell physician or patient information. I even received a letter from the CEO stating this.

After reading your other blog posts, I was disappointing to see that you are not even a doctor, nor are you qualified to make a recommendation on an Electronic Health Record. Your endorsement to use google docs as an EHR in not only illegal but almost blasphemous, as this product is not even HIPAA compliant. Your juvenile youtube video about 23andme was particularly telling about your professionalism, or lack there of. Other readers can see what I am referring to here: http://www.youtube.com/watch#!v=euO3-h9_jdQ&feature=related

When you graduate school, finish your residence, start practicing medicine, or even reach puberty, you might be a reliable source to recommend how to practice medicine and what tools to use, but until then, you’re just a little social medial weasel attempting to get his 15 minutes of fame.

PS – why did you reject my comment on your blog? Are you afraid of a little debate?

I do agree that free, advertising-supported Google Docs and Gmail is not appropriate for medicine. That is why I advocate purchasing a license from Google to resolve the relevant privacy and ethical issues which would otherwise disqualifies these service from medical use.

I’m not qualified to comment about blasphemy.