HJBR May/Jun 2026

HEALTHCARE JOURNAL OF BATON ROUGE I  MAY / JUN 2026 21 while improving data capture and access — have shifted a substantial clerical load onto clinicians. Increasingly, there is concern that burnout is not simply a function of workload, but of misalignment — where over-digitization, at the expense of human connection, distanc- es physicians from the very relationships and sense of purpose that drew them into medi- cine. For technology to fulfill its promise in healthcare, it must do more than digitize work; it must eliminate the mundane, restore atten- tion to the patient, and create space for the hu- man connection that sustains both patients and those who care for them. As I reflect on my own journey in medicine, I cannot ignore the role that the electronic medical record has played, at least in part, in one of the most difficult decisions of my career: stepping away from a full-time practice and the thousands of patients I had come to care about deeply. I still see patients one day a week in a clinic model I designed myself, and while that day is often the most fulfilling of my week, I con- tinue to feel the friction imposed by current iterations of the EMR on how I deliver care. My practice style has always been comprehensive; I am comfortable managing a wide spectrum of conditions and I take pride in providing that level of continuity for my patients. But that breadth comes at a cost within the current digi- tal framework. Each encounter requires synthe- sizing a vast and fragmented dataset: medica- tions across all conditions, multi-organ system histories, preventive care, acute complaints, and chronic disease management, all of which must be meticulously documented. In contrast, specialists often operate within a narrower clinical scope — focused histories, targeted medication reviews, and problem- specific documentation. For the primary care internist, the cognitive and administrative load is fundamentally different. Our role demands not only clinical breadth, but also the aggre- gation, organization, and reconciliation of in- formation across the entire continuum of care. The EMR, rather than simplifying this respon- sibility, often amplifies it. The result is a level of preparatory work that extends well beyond the visit itself: On the evening before my clinic day, I routinely spend about two hours review- ing charts and synthesizing data so that I can be fully prepared to deliver care that is thoughtful, personalized, and comprehensive. A practical example illustrates this well. As part of my pre- charting workflow, I routinely assess for meta- bolic dysfunction–associated steatotic liver disease (MASLD/MASH) in all patients who are overweight or have obesity. This requires man- ually reviewing historical liver enzymes for evi- dence of elevation, scanning prior imaging for hepatic steatosis, and calculating a Fib-4 score using a dot phrase. Based on that synthesis, I may identify the need for additional steps so that these issues can be addressed thought- fully during the visit itself. While these actions could be deferred until after the encounter, do- ing so would fragment the conversation and delay care. Instead, they require deliberate preparation in advance — time that is largely invisible, but essential to delivering high-quali- ty, comprehensive care. A similar pattern emerges in cardiovascular risk assessment, which has become a central component of managing patients with cardio- metabolic disease. As part of my pre-charting workflow, I routinely review the most recent lipid panel, verify whether a lipoprotein(a) level Source: Luke Fildes, The Doctor (1891), oil on canvas, Tate Britain, London. Image via Wikimedia Commons (public domain).