My doctors seem to be following a checklist rather than adapting their questions to me.  Why is that?

The EHR programs have a fairly rigid format for recording information gathered during your visit with the doctor.  After all the questions are asked, after the physical examination is done, after the doctors makes a list of your problems identified or suspected, and after the doctor recommends or undertakes interventions for these problems, the computer takes the billing choices out of your doctor's hands and decides how much the doctor should be paid for that visit.  The computer program adds up the number of questions answered during your visit, the number of physical findings checked from a list, the number of diagnoses your doctor lists as active or inactive problems, and the number of interventions (diagnostic tests, prescriptions given, or actions recommended to you).  Using insurance company and Medicare definitions of work effort, the computer adds up the number of entries from these various checklists and uses the number of data entries to calculate the amount of work the doctor did during your visit.  The computer decides the complexity of your visit and chooses a billing code which is subsequently transmitted to the practice's accounting software and then sent electronically as a claim to your health insurance company.  Electronic prescriptions are part of the work done, and the computer program will send prescriptions over the internet to your local pharmacy or your prescription benefit plan warehouse.