Shawn Martin, the AAFP Senior Vice President of Practice Advancement and Policy at AAFP, recently wrote a blog about how Electronic Health Records (EHRs) suck and about the need for competition and innovation in the EHR space. In the intro to his article he writes that there are two issues that always rise to the fore when he talks to family physicians around the country: “The first is the disdain family physicians, really all physicians, have for electronic health records. The second is how the EHR industry, to date, has failed in its core mission.”

I’d like to take each of these reflections in turn. The first is the claim that all physicians disdain EHRs. Is it true? As a young family physician, I don’t think so, nor do many of my fellow physicians. We trained on EPIC and often talk about how much we like it. But these conversations are anecdotal and EPIC often receives high marks in satisfaction surveys.

Looking at physician satisfaction surveys with larger samples across multiple EHRs, we see a more complicated picture than the one Martin paints. Healthcare IT News performs an EHR satisfaction survey every year and in 2017 they found that nearly half of respondents rated their satisfaction as 8 or more on a scale of 1 to 10. Additionally, they are seeing higher favorability scores year over year. Many surveys find less favorable results, but none of them show universal disdain for EHRs. Age seems to be one factor in how physicians perceive EHRs and interoperability remains a big challenge. Of note, the last EHR satisfaction survey AAFP conducted was done in 2012.

Martin’s second claim is that the EHR industry has failed in its mission. To make he point he goes back to 2004 and compares the performance of current EHRs against the goals President Bush set forth in his State of the Union speech that year. Bush spoke of an EHR future in which medical information would be more available at the time of care, quality would improve, medical errors would decline, and costs would be reduced by improving efficiencies. Instead, Martin writes that “the promise of EHRs has failed epically to meet the expectations outlined in the SOTU speech.”

Unfortunately, Martin offers no data to back up his claims. A 2014 systematic review in the Annals of Internal Medicine suggests that EHRs improve quality and safety in certain applications. Cost and efficiency findings were mixed in this study, although a more recent systematic review from 2016 showed improved time efficiency. While EHRs have not dramatically revolutionized outcomes and the practice of medicine on the whole, could we truly have ever expected them to?

And while that utopian future never came, there are obvious benefits that so often get lost in the drumbeat of pessimistic physician attitudes. I’d rather not go back to the days when pharmacists couldn’t read the handwriting on patient prescriptions, when bar code scanning wasn’t a routine part of inpatient medication dispensing, and when notes from specialists were (unreliably) faxed to primary care offices.

Beyond Martin’s opening claims, and the lack of evidence for them, lies his true message (and bias): EHRs suck. Martin describes it like this: “They suck as products, and they suck the life out of everyone that uses them.” But as we’ve seen above, EHRs aren’t as disdained as Martin’s informal conversations with docs around the country seem to suggest they are. And they work better than he claims they do.

The real frustration I believe Martin has with EHRs is that they’re not sexy in the way tech products these days often are. He cites different Silicon Valley companies such as Facebook and Uber as examples of what EHR technology could be like, if only there were more innovation and competition. I share this dream! I’ve even gone so far as to sketch an outline of what an app might look like if it was as user-centered and easy to use as Airbnb. I believe such an app is possible in theory—but not in practice.

Why not? Because physicians are inflexible and don’t like to be told what to do. Because healthcare systems are huge and it is very hard to turn a cruise ship on a dime. And because billing will always rule the roost.

But the most frustrating reason, in my opinion, is the first. The others are arguably bigger and more challenging to solve, but the inflexible attitude of physicians who are resistant to technological innovation and experimentation is a major issue. It is this attitude that underlies the hyper-critical physician feedback of EHRs when policy people (like Martin) have one-on-ones with docs. It is this attitude that perpetuates the narrative that EHRs are doomed to disappoint. And it is this attitude that ultimately limits the ability of new companies to enter the EHR space. Physicians don’t like change and are unwilling to give something new a shot.

It isn’t true that all physicians disdain EHRs. It isn’t true that EHRs have failed in their core mission. And it isn’t true that all the EHR products out there suck. But it remains true that physicians are inflexible in their workflows. It remains true that physicians lack a sense of technological experimentation. And it remains true that no sexy tech startup has cracked the market. It might even be the case that rapid-cycle tech product innovation in health care just might not be that feasible.

So let’s stop the EHR shaming and instead focus on small technology pilots within large institutions, promote integrations between large EHR providers and smaller tech innovators, and come at the problem with a sense of experimentation rather than inevitable dread.