David Morin, MD -- Balancing Traditional Pediatric Care
with Cutting-Edge Practice Management Technology
MD News South of Boston March/April 2003
By Karen Ellery-Jones

Dr. David P. Morin is what every parent wishes for in a pediatrician. With a soothing voice, not unlike legendary and beloved late Fred Rogers, and a gentle, gracious manner, Dr. Morin has been caring for South Shore children for the past 22 years, seeing himself as both a protector and advocate for all his patients. "We are obligated. That's our job," he says in a slow, rhythmic cadence that seemingly belies the passion and determination that drove him to pediatrics over two decades ago.

After graduating with a B. A. in Psychology from Stanford University, Dr. Morin joined the Peace Corps, teaching English as a second language in norwest India for little over a year. After returning from India, he took a summer job in a hospital's kitchen, cooking breakfast, and woke up one day realizing that he wanted to go to medical school. "I'll just go to Harvard Medical School and talk to one of the admissions guys," he says, noting that the admissions counselor was also a child psychologist. "He asked me how long I had wanted to become a doctor, and I said two days. He took me seriously and told me what I had to do. He said if it didn't work out to call him, but I knew it was going to work out. I never had any question it wasn't going to work out. I just knew it," Dr. Morin says.

Fulfilling the additional courses he needed for medical school at Harvard, BU and MIT, Dr. Morin was accepted at the University of Vermont College of Medicine in the fall of 1971 where, three weeks into the semester and "extremely fed up with being in class," he spoke to a member of the faculty who was a pediatrician, telling her that he wanted to be a pediatrician but hated going to class. "I said, 'I'll read whatever you tell me.' She said fine and mentored me all the way through," he recalls fondly. "I established a curriculum of one at the University of Vermont."

Following a three-year naval commitment in Portsmouth, VA, Dr. Morin returned to the South Shore and began his pediatric practice, housed in the same building as it is today, though a new, larger, more family-friendly office is currently under construction down the street. Originally purchased by Dr. Morin's parents in the late '60s, the 1700s era farmhouse is being expanded to accommodate Scituate Pediatrics and other tenants next year.

When Dr. Morin first began practicing in 1980, he was the sole employee, handling patient exams, telephones, billing and reception. Today, Scituate Pediatrics has four physicians, three nurse practitioners, one physician assistant, a team of skilled clinical and administrative staff and an impressive electronic medical records system that, according to Dr. Morin, allows he and his staff to get back to practicing medicine "the way it used to be."

"The whole purpose of electronic medical records, I think, is to take what you have to do and make it easier to actually get it all done," explains Dr. Morin, who purchased the system in July 2002 from Wang Healthcare System in Billerica. He recalls a hectic Monday less than three weeks into using the records system, when there were only two physicians on duty.

"When I left for the day, every patient was documented. And that never used to happen." Less than three months into using the system, say Dr. Morin, "no one wanted to go back."

Physicians' Workstation, the electronic medical records system that Dr. Morin uses, was designed by physicians and allows users to modify several areas in the program to reflect their specific style of practice.

"The whole purpose of electronic medical records, I think, is to take what you have to do and make it easier to actually get it all done." David Morin, M.D.

"The start-up package was not only flexible, but we were able to customize it. When we got into the program, we said, "We don't ask that question that way,' and it was changed." According to Wang Healthcare, Physicians' Workstation easily "conforms to how physicians and caregivers work. Electronic forms can be designed to look exactly like the paper forms, and because the software supports several input devices -- keyboard and mouse, voice recognition, electronic pens and tablets, as well as transcription and scans of paper materials -- physicians work in ways that make them most comfortable."

With computer access in every exam room, Dr. Morin and his associates are able to access their patients' charts by using simple key strokes. Charts are immediately updated and accurate coding is completed as soon as the patient visit has ended.

Dr. Morin explains that it was often difficult to prove, without fully documenting in the charts, that he did, for example, a level 4 visit as opposed to a level 2. "I did a level 4. I did notice all of those things, but I didn't have time to write them all. So they (insurance companies) say. "Well, you know if you didn't write them down then you didn't look at their eyes.' But as soon as I walked into the room, I was looking at the size of their pupils, the whites of their eyes, how they are breathing, nostrils flared, nostrils not, anxiety, not anxiety, breathing fast, not breathing fast, color of nails, etc." He adds, "Not only does it help you document the things you did, but also codes what you did. You don't have to worry that someone takes your chart and codes out what you did for the day pushing a level 3 instead of 4. It's consistent and probably a lot more honest."

Clearly impressed with how the system has alleviated the problems associated with conventional paper charts, Dr. Morin also praises the ease with which he can print out various reports patients need for school or camp, eliminating the often time-consuming steps of retrieving charts, photocopying and filling out forms.

Patient not only benefit from having updated charts and access to a variety of medical information, but also have a tremendous advantage when they are sick after office hours. "I can take this home (his laptop), plug it in a my station at home, and when people call up at night I have immediate access to their charts."

"One of the questions I love to ask kids is 'What do you do for fun?' One out of 10 will have the first response: 'I play with my friends.' The other nine will, for example, say, 'play hockey'. They go right to the specifics -- organized fun." David P. Morin, M.D.

Although he and his staff were trained to use the system and are now comfortable using the software, Dr. Morin compares the initial learning phase to bringing home a newborn. "Your friends and relatives talk to you about your first child. And you have buckets of advice and training. You might have even cared for your nieces and nephews, but when you have your first child for the first three or four nights at home, it doesn't matter how good the trainers were or how attentive you were during training. By the third or fourth month, most children sleep well and that's about the time it takes to get comfortable with this process." He is now so familiar with the program he knows which questions are coming up.

By asking children seemingly innocuous questions, Dr. Morin gains a better understanding of his patients' well-being. "One of the questions I love to ask kids is 'What do you do for fun?' One out of 10 will have the first response: 'I play with my friends.' The other nine will, for example, say, 'play hockey'. They go right to the specifics -- organized fun."

Dr. Morin says that parents do not necessarily recognize that children who are expected to be on their best behavior while attending school, sports practices and music lessons, fail to have time to "decompress" when shuttled from one organized activity to another. And he isn't afraid to let parents know when their child has too many activities. "I do it all the time," he admits, saying that it is exceedingly more difficult for today's children to survive effectively because of varying stress factors not seen in previous generations, citing the controversial MCAS exams as one example.

Dr. Morin stresses the importance of play and preserving time after school. "Play clothes and learning to read" are equally important.