NDA Journal 10 Featured Article Scott MacDonald, MD, chief medical information officer at UC Davis Health in Sacramento, California, told Medscape Medical News that copy-and-paste abuse has come up a few times over the years in investigations of clinical errors. Physicians can be held accountable for copy-and-paste by Medicare contractors and in malpractice lawsuits, but the most obvious way is at their place of work: A practice, hospital, or health system. One physician has lost staff privileges, but more typically, coding clerks or colleagues talk to offending physicians and try to educate them on proper use of copy-and-paste. Educational outreach, however, is often ineffective, said Robert Hirschtick, MD, a retired teaching physician at Northwestern University Feinberg School of Medicine, Chicago, Illinois. “The physician may be directed to take an online course,” he said. “When they take the course, the goal is to get it done with, rather than to learn something new.” Hirschtick’s articles on copy-andpaste, including one titled, “Sloppy and Paste,” have put him at the front lines of the debate. “This is an ethical issue,” he told Medscape Medical News. He agrees that some forms of copy-and-paste are permissible, but in many cases, “it is intellectually dishonest and potentially even plagiarism,” he said. Hirschtick argues that copy-and-paste policies need more teeth. “Tying violations to compensation would be quite effective,” he said. “Even if physicians were rarely penalized, just knowing that it could happen to you might be enough. But I haven’t heard of anyone doing this.” 0 Definitions of what is not acceptable vary, but most of these policies oppose copying someone else’s notes and direct physicians to indicate the origin of pasted material. »
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