Friday, September 9, 2011

Do Computers Really Come Between Doctors and Patients? Is the Future Here?

One of my favorite movies is Back to the Future starring Michael J. Fox.  I must admit after reading this New York Times piece, titled "When Computers Come Between Doctors and Patients" I have to wonder.

Am I fortunate to be coming from the future?  Because I completely disagree with Dr. Danielle Ofri, again.

I've had the privilege and opportunity to work in a medical group which has deployed the world's largest civilian electronic medical record and have been using it since the spring of 2006.  I don't see the issue quite as much as Dr. Ofri did.  It is possible that she examined patients in her office with a desk rather than an examination room.

If placed and mounted correctly in the exam room, the computer actually is an asset and can improve the doctor patient relationship. It is part of the office visit. The flat screen monitor can be rotated to begin a meaningful dialogue between the patient and I. We review the lab work together as well as the trends. Look at xrays. Who needs anatomy flip charts when I can google any image instantly? Patient friendly information to reinforce our discussion is a click away.

The computer can certainly enhance the doctor patient visit. Like any skill, unless we deliberately practice in getting better, we will simply find the new method awkward and unnatural.

And the same goes for emailing patients securely.  An October 2010 article in Pediatrics found that for a 127 families only 5 emails were generated compared to over 2300 phone calls over an 8 month period.  The data doesn't lie.

The conclusion of the article was that -

Although these patients/families expressed strong interest in e-mailing, secure Web messaging was less convenient than using the phone, too technically cumbersome, lacked a personal touch, and was used only by a handful of patients.

So doctors could conclude that patients really don't want to email their doctor.  What a relief because the majority of patients still do not have the option to do so and doctors don't really want to do it.  (Though there could be compelling business reasons not to offer email to patients even if the doctors were technically savvy enough to offer it).

But yet this earlier press release in July 2010 may cause doctors to pause before returning to paper charts, pens, and phones.  This study found that over a two month period, 35,000 patients generated 556,000 email threads.

So what does this all mean?  As doctors we need to change our mindset and look at these changes as opportunities for the medical field to provide care that is increasingly worry-free, hassle-free, and personalized.

The future is here.  That means embracing the computer.

None of my patients would ever go back.

Neither would I.

Speaking of Back to the Future, I understand a limited supply of Marty McFly's shoes are now available for purchase!  Bids are at $4000!


4 comments:

Laura said...

David what strikes me as odd is that so many people don't like the use of emails. I work for a company that provides telemedicine called Dial Doctors. We provide consults through phone or email. I can't tell you how many times patient prefer email. Granted certain conditions, mostly skin care related, benefit from things only email could provide like pictures.

I think that patients could be fearing getting lost in communication through email. If you can email your grandson then you can definitely email your doctor. "Technical" issues are probably fueled by fear that not listening or talking to the doctor could lead to poor care. Another thing to consider how the natural flow of conversation could be lost on email.

Hopefully more people will adopt these technologies in order to help reduce hospitals over-capacities.

Anonymous said...

not just computer, but computer with internet can do great job between a doc and patient.

telemedicine is the future of health industry.






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Jessica said...

My name is Jessica, and I work for Zócalo Public Square, a Los Angeles-based ideas web publication and event series. We thought you might be interested in checking out Zócalo's recent piece on a new system of medical diagnosis technology that aims to save patients time and money. We'd love to know what you think.

http://zocalopublicsquare.org/thepublicsquare/2011/09/12/dear-john-you-have-psoriasis/read/nexus/

Michelle said...

I always find that email is more efficient, but you need to have email and phone as points of communication. Emails aren't immediately responded to. Phone calls are most of the time.

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