DAVID GREENE, HOST:
And let's hear now about changes in the medical field in the modern era. The federal government has introduced new rules designed to improve health care by bringing doctors into the electronic age, but this can be a pretty big burden for small medical practices. Annie Feidt from Alaska Public Media reports.
ANNIE FEIDT, BYLINE: Dr. Oliver Korshin is 71. He practices ophthalmology three days a week in the same small office in East Anchorage he's had for three decades. Many of his patients have aged into their Medicare years right along with him, like the 86-year-old visiting on a recent afternoon.
OLIVER KORSHIN: Come on forward and put your chin on the chin rest, and your head has to be right against the band.
FEIDT: Korshin employs one part-time nurse. And his lease runs out in four years when he will be 75 and expects to retire. He says for his tiny practice, electronic medical records just don't make sense. It would cost too much to install and maintain a new system.
KORSHIN: No possible business model would endorse that kind of implementation in a practice like mine. That's crazy.
FEIDT: But starting next year, the federal government will penalize him for not using EMRs, withholding 1 percent of his Medicare payments. Korshin will lose another 1.5 percent next year for failing to enroll in PQRS, a federal program that requires doctors to report quality data. And then there's ICD-10, a new coding system also set to take effect the fall of 2015. Korshin says he can't keep up.
KORSHIN: This flurry of things one has to comply with mean that unless you work for a large organization like a hospital that can devote specific staff and time to dealing with these issues, there's no economy of scale. I can't share these expenses with anybody.
FEIDT: According to Mike Haugen of the Alaska State Medical Association, Korshin has company.
MIKE HAUGEN: Most practices in Alaska are one-, two- and three-doctor practices. The number of really large practices - and that's relative in Alaska - you can practically count them on one hand.
FEIDT: Haugen says many doctors feel overwhelmed by the federal requirements for practicing medicine. And since half the doctors in Alaska are over the age of 50, he worries they'll consider retiring early.
HAUGEN: It's a very quiet process, and that for me - that's the scary part because access to care in this state is a real issue.
FEIDT: But a lot of doctors would tolerate the requirements if they had more support, says Rebecca Madison of Alaska eHealth Network. The organization offers federal grants to providers to implement EMRs. And she helps doctors see the benefits of electronic systems, like lowering billing costs.
REBECCA MADISON: We work with the providers to ensure that they have the best experience they can going into an electronic health record because it really is changing your entire practice. It's not easy.
FEIDT: But she hopes to convince as many as possible it's worthwhile to make the switch. For NPR News, I'm Annie Feidt in Anchorage.
GREENE: Annie's story is part of a reporting partnership with NPR, Alaska Public Media and Kaiser Health News.
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