Not retiring at 65: Physician goes from anti-EHR to pro-ACO

By Diana Manos
11:00 AM

Jeffrey Selwyn, an internist at New Pueblo Medicine in Tucson, Ariz., is 65, but he says he's nowhere near retiring. Unlike many docs his age who are throwing in the towel due to the increased pressures on physicians to use EHRs, Selwyn is excited. He wasn't always a fan, however.

As he looks back, Selwyn admits he was something of a spokesman for older physicians who didn’t want to learn the time-consuming new way of keeping patient records. He often said so in the local newspaper. The way he did things on paper was fine, he says. It was working. He was very organized. When his practice began adopting EHRs eight years ago, he was the last physician there to get on board.

[See also: Majority of ACOs in shared savings program are physician-led.]

“It was a tough transition; I was a tough dude to get moving,” he explains. “It was a big change from my routine and the way that I would do things.” Selwyn says at first he had to cut the number of his patient visits down to allow himself more time to complete each visit using EHRs.

“But after the many days that it took to ramp up, I learned more and I studied more from a remote site. I’ve always accepted a challenge like many physicians,” Selwyn says.

After even more practice, he learned the nuances of the EHR and began to see benefits. “It’s interesting at end of my career to see the difference in what EHRs can do for interoperability and patients – what they can do to streamline patient care. No one can see that at first,” Selway says. “It’s hard to look into the future and see what you can gain from doing something until you actually go through it – until until you are there. It was mind-expanding, and a patient-relevant experience, and it allowed me to see a big change.”

Selwyn wasn’t computer illiterate prior to EHR adoption. He used computers for personal use. He also was a huge proponent of the medical home model, something his practice has always strived to provide.

Now, Selwyn is president of the board of Arizona Connected Care, one of the first accountable care organizations (ACOs) to participate in the Medicare Shared Savings Program, a federal program to lower costs and improve care. Arizona Connected Care was one of the first 27 ACOs selected to participate in the program last month.

Selwyn is passionate about the program and was eager to sign on in a leadership role, he explains. He hopes to be an inspiration to other doctors, especially those who are resisting EHR adoption for fear it will load them with yet more work.

[See also: ACO program is asking too much, says expert.]

“I know their pain," he says. "I know what it’s like. But if we can just gather data, we can help them work smarter, not harder.”

As far as the kind of care an ACO can provide? Selwyn says the model can deliver, where HMOs couldn’t, because the technology is there now. With regard to consolidated care – the use of data to promote best practices and pre-emptive measures to keep patients healthier before they get sicker – Selwyn says, "this is what we were trained to do, and I want to do it before I quit.”