As an emergency physician and former IT engineer with Unix system administration background, I'll say that most of the important software and hardware choices are made by the IT department and C-level executives without any input by physicians what-so-ever. I'll reply to your points line by line:
> 1) Over emphasis on the needs of the physicians over the needs of the patients and the other areas of the healthsystems. Many important IT choices are
> made by doctors and not the professionals who were hired to be experts in these areas. That and the physicians are notorious for having almost no respect
> for other professionals who are not a doctor.
The healthsystem SHOULD EMPHASIS the need of the PHYSICIAN over that of the patient when we are the ones using the EMR, PACS (picture archiving and communication system), network drive, intranet, and other features day in and day out. The needs of the patient come into play when interfacing with these systems to retrieve their laboratory and imaging results, physician communication, and others when at home or elsewhere. If the IT department doesn't like this, then too bad as the users needs outweigh yours -- remember that this is coming from a practicing clinician.
Just keep trotting out the old-line about how physicians have no respect for any other professionals as there's no basis for it in the real world. If you look around at the landscape of healthcare in the US, you'll see that it's the physicians that are dis-respected every day at the hands of the administration, fellow professionals, and patients.
> 2) Easy money. Money comes easy to these organizations. This plus...
Money does not come easy to any of these organizations unless your are a huge health system such as Mount Sinai in NYC or Mayo Clinic or any of the other health systems around the country. If you're that big, you can tell the insurance companies how much they will need to pay up. However, the majority of hospitals are 1-2 hospitals and have a very limited budget for many things including EMRs, IT staff and departments, and ultimately hardware and software. It's not like they have money to burn...
> 3) Non-profit tax status and requirements to spend or invest profits earned. This creates an environment of plentiful budgets where waste runs rampant, and
> concern over things such as nepotism and incompetence aren't as important as they would be in other companies
IT departments in hospitals are rampant with nepotism, incompetence, and wastefullness. The heads of the security, network, and support divisions have no clue when it comes to support clinicians including physicians, nurses, LPNs, or any other staff that requires using the computer for any health related work.