Corporate headquarters in Washington D.C. has decided that we are going to use an electronic medical record. In order to enforce their mandate they offer the company a whole lot of TARP money. We have been picked to be a trial institution for a new program. Now all our medical decisions will be made 3000 miles away in the Silicon Valley. You can make changes but it is so difficult that eventually you will concede and become Robo-Doc and do what corporate wants or what was formally known as "go along to get along". There will be less time spent with the patient and more with the lap-top. Efficiency, safety and morale will suffer but if we all hang in there somewhere down the line corporate will get a big pot of Obama money. As far as the lab rats go, some are ready to jump ship.