Why wouldn’t a doctor report someone? According to the survey, due to the beliefs that someone else would do it and that reporting incompetence wouldn’t actually make any difference, in addition to the fear of retribution. The authors also noted that physicians who belonged to one- or two-person practices, are a racial or ethnic minority or who graduated from non-U.S. med schools were less likely to report a physician colleague. Those at hospitals or med schools were most likely to do so.

There will be additional criteria that will have to be met to qualify for bonuses in 2013 and 2015. But 80% of survey respondents said they were concerned or very concerned that they won’t be able to meet the meaningful use requirements by 2015. Specifically, they’re worried about the requirements that will actually mean changing how care is delivered — such as using computerized evidence-based guidelines when ordering tests or procedures — says Bruce Henderson, leader of the electronic health records practice at PwC. “There’s lots of focus on the technology, but this is really about standardizing care processes at the highest level of quality with an eye towards the reduction of costs,” he tells the Health Blog. That means changing how doctors, nurses and other personnel work — and changing how anyone does his or her job is not easy.