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What if EHRs, MIPS, and MACRA all stood for something else — something truly meaningful?

Fam Pract Manag. 2019;26(3):36

Author disclosure: no relevant financial affiliations disclosed.

Copyright © 2019 Amaryllis Sánchez Wohlever, MD.

I recently read that there are 10 nonclinical administrators and staff for every physician in the United States. This means a greater portion of every health care dollar goes to paying for staff who have nothing to do with direct patient care. Yet these administrators dictate much of what we physicians do. We are forced to see more patients in less time, although many are sicker and on more medications than patients 10 years ago. We are asked to supervise others on the health care team, and we carry an unfair burden of liability. No wonder physician burnout is so high. What's remarkable is that it isn't higher. Despite mounting and exhausting obstacles to excellent, compassionate care, we still strive to care for people every day according to our high standards, placing patients first. I believe this is due to our high levels of resilience and dedication.

But enough is enough. After becoming a patient and experiencing the “other side” of health care, I was inspired to write the following poem to encourage my colleagues to take a stand — for our patients and ourselves.

A New Lexicon for Physicians

Imagine if PQRS and ICD-10,

EHRs and the looming MACRA,

MIPS, and APMs

all stood for something else,

like measures of meaning and care

aligned with what patients need

and with who we are:

true servants at heart.

These sly abbreviations

champion some other dream

that hijacked our profession

and disrupts the health care team.

But we refuse to abbreviate care,

cut corners, detach,

and forget who we are.

I dream of autonomy

and its friend, common sense,

and that sacred relationship

we all still defend.

I dream of scaling that fence

built by faceless EHRs

that split

my vocation … from … the human person

I vowed to assist.

So why not rename

the despised click-click-clicker

that keeps us a–u–t–o–m–a–t–e–d

and every misnomer that traps us

'til we're duly subordinated.

Here's a new dictionary of medical terms

born of our noble dream, not theirs.

Physician, arise! This is my earnest plea.

Quit playing someone else's maddening game.

Rules that hinder, intrude, disrespect, and inflame.

Success is, now, LISTEN — up to you and me.

Mandates and regulations keep choking.

Administrators blindly add more stress.

Care suffers while we smolder, too busy to voice our distress.

Remember your Hippocratic Oath?

Anyone else take that pledge?

We know what matters most.

Our patients are first.

Make another vow, for the future's at stake.

It's time to stand up; we must stay wide awake.

Patients deserve much less haste, something better.

Sacred relationships front and center — forever.

I believe in you,

Colleague. You're ready!

Dare to speak your truth and to STAND!

10 thousand more voices all over this land.

A new future requires a return to the basics.

Practice your craft. We cannot be complacent.

Make everything count for you and your patient.

It is time to heal our profession.

Let's scrub in and start healing our nation.

Let us all work together to see




Including our own.


The opinions expressed here do not necessarily represent those of FPM or our publisher, the American Academy of Family Physicians. We encourage you to share your views. Send comments to, or add your comments below.

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