A survey of hundreds of U.S. physicians found that while most know about the carrot Medicare is dangling to encourage adoption of electronic health records, many don't know about the stick.

In a survey of more than 500 doctors, released Wednesday, more than one-third didn't know about Medicare penalties for not adopting EHR, and of those who didn't know, most said the penalties wouldn't spur them to implement the system.

The survey was conducted by Physicians' Reciprocal Insurers, a Long Island-based insurance company.

The survey found that while 85 percent of doctors knew that the Centers for Medicare and Medicaid Services would start doling out incentive payments to doctors starting next year for being "meaningful users" of EHRs, more than 35 percent did not know that Medicare also plans to assess penalties for those who don't adopt the software by 2015.

"The penalties are equal to a one percent reduction of the physician's annual Medicare payments per year up to five percent," the insurance company said.

Still, of those who weren't aware of the coming penalties, around 65 percent said they weren't enough to drive them into getting EHR installed.

Topping the list of concerns were cost and training of staff. Of physicians who said they do plan to adopt EHRs, a full 85 percent said they were "somewhat" or "very" concerned about the cost of adopting, with seven out of 10 respondents saying they expected to shell out more than $15,000, according to Physicians' Reciprocal. And nearly 79 percent were worried about training staff to run the EHR, the group said.

Nonetheless, a majority of doctors, around 58 percent, did say, in the end, the system would improve the quality of patient care.

"The ability to pull patient records and use the data in a collaborative environment will change the way health care is administered and contribute to the reduction of risk," Physicians' Reciprocal's associate director of risk management, Gerri Donohue, said in prepared remarks. "It's encouraging to see that the majority of physicians understand this benefit."

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