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My endocrinologist walks in with her laptop. But she sits next to me and turns it around so we can both see what's going on, trends, scans, etc. it's been very helpful. I've had no issues with her rushing me through.
Don't blame the technology. Blame the doctor if you are having issues.
On my recent visit to a new PCP I didn't even have to fill out a new patient form. The nurse just ask me the questions and recorded them on her laptop. Everything is going electronic now. The doctor came in with his laptop, didn't even introduce himself or anything, just began working on the laptop. The whole visit was very impersonal. But what can ya do?
It takes practice and skill to be able to document in an electronic record at the patient bedside. I've had providers who are very good at it, and providers who were terrible. I would probably also switch providers if mine seemed too distracted by their laptop to hear what I'm saying.
As far as percentage of time spent on data entry versus direct patient care, I suspect it was not very different and possibly worse when we used paper charts. (I also suspect there were a lot more errors when we used paper charts.) I work in healthcare and even working in a system that is rather progressive with electronic records, our providers still have to spend a huge amount of time acknowledging orders, filling out forms and assessments, physically signing and e-signing things, etc. etc. Everything has to be documented; government regulations + insurance companies want everything documented.
Our doctors throughout our medical system, do not use lap tops. Each exam room of any type, is equipped with a computer work station, hooked into the mainframe. The nurse brings up your records, takes the things she is to check, entering the information. The Dr comes in, and everything is there. That includes the lab tests that may have been taken 15 minutes before, x-rays, other doctors records. The doctor no not only talks to you, does his own checks, and has the other records to compare, etc. They have so much more available, than in the old days of paper charts. The Dr can check about potential medications, etc., and when they write a prescription they write it on the computer, and it is automatically forwarded to my pharmacy of record to get it ready for me to go by and pick it up.
If they are going to write a prescription, they have all your current prescriptions no matter who in the system gave them to you, so when the write a new prescription the computer checks to see if it is compatible and safe to use with your other medications. If not, they know right then, and suggest another medication.
Example: A top cardiologist I was referred to, though I was going to have to have a pace maker and was setting it up to happen, but the computer though different and said I had a probable problem from one of the drugs and changing the prescription from another doctor found that it was the problem. No pace maker, changed a medication and returned to good health. Without the computer watching out for me, I would be walking around with a pace maker today and would not be in near as good health.
They are working with your entire medical history, and can do a much better job than they did a few years ago. The computer, is a great aid to your doctor to solve your medical problem. Takes the guess work out of medical care.
Don't get mad at your doctor for using a computer to aid him/her in handling your medical problem. They are just using a modern tool, to give you better medical care. It is like the auto repair business. A few years ago, the mechanic guessed what your problem was, and fixed the car by trial and error. Today they just hook up to a computer (all late model cars have a computer connection waiting to be used), and the computer reads out what the problem is. Now they are using the computer, to aid their own knowledge to assist you and you are getting much better medical care.
Don't get mad when your doctor uses a computer, just be darn glad he/she does use one. He/she has moved from the primitive medical days guessing to what you need, to modern tools that allow the doctor to evaluate your problem and can give you better medical care.
Location: Mokelumne Hill, CA & El Pescadero, BCS MX.
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Quote:
Originally Posted by suzy_q2010
I actualy see an internist who is in solo practice, uses paper charts, and has no plans to computerize. He is not an old geezer, either.
He examines me, talks to me, hands me paper prescripitons, I carry those to the pharmacy, get groceries while it is being filled, then go home.
Whatever notes he writes are completed after I leave.
My wife is a Nurse Practitioner who sees a doc who writes out stuff like that. In her practice she asks how the PT would like to have stuff delivered. I wouldn't want to have a doc that does it old school like your internist. She carries an IPad with her into the exam rooms. All the current information, all the recommended practices, all the potential drug interactions right in front of her. How quaint your doc doesn't care for the technology. I'd switch docs in an instant!
What really blows my mind is how fixated the medical profession is about faxing documents. Are you freaking kidding me? The 20th century called, they want their technology back.
My wife is a Nurse Practitioner who sees a doc who writes out stuff like that. In her practice she asks how the PT would like to have stuff delivered. I wouldn't want to have a doc that does it old school like your internist. She carries an IPad with her into the exam rooms. All the current information, all the recommended practices, all the potential drug interactions right in front of her. How quaint your doc doesn't care for the technology. I'd switch docs in an instant!
What really blows my mind is how fixated the medical profession is about faxing documents. Are you freaking kidding me? The 20th century called, they want their technology back.
I chose an internist who is experienced and knowledgeable. He doesn't need to look it up. I would not want a doc who was dependent on the computer for everything.
Mine uses computerized records but I wouldn't say she spends any more time writing on the computer than she would on a chart. Also, when I was bitten by a dog last winter, she wanted to make sure what the proper antibiotic protocol was (it involved two, one of which isn't that common, and the doses were higher than usually prescribed), and she was able to look it up right in the exam room, then send the prescription directly to my pharmacy via computer so that it was ready to pick up when I arrived there. She wanted to make sure she was treating the bite correctly, and since she doesn't see dog bites that often, she wanted to look it up. I would rather have her do that than guess incorrectly. So I think if used properly, they save a lot of time and lead to better care.
Mine uses computerized records but I wouldn't say she spends any more time writing on the computer than she would on a chart. Also, when I was bitten by a dog last winter, she wanted to make sure what the proper antibiotic protocol was (it involved two, one of which isn't that common, and the doses were higher than usually prescribed), and she was able to look it up right in the exam room, then send the prescription directly to my pharmacy via computer so that it was ready to pick up when I arrived there. She wanted to make sure she was treating the bite correctly, and since she doesn't see dog bites that often, she wanted to look it up. I would rather have her do that than guess incorrectly. So I think if used properly, they save a lot of time and lead to better care.
I doubt that your doctor used the EHR to find that information, though. Most likely Google.
I chose an internist who is experienced and knowledgeable. He doesn't need to look it up. I would not want a doc who was dependent on the computer for everything.
There is no such thing as an internist that knows everything. If they are relying only on their memory, there is no way they can remember all the medications, etc., available to treat you. No way to remember everything about the possibility of a certain medication reacting badly with the other medications given you by another doctor. No way that the doctor would have been alerted that a medication given by another doctor would react badly, and cause the exact problem I had.
What you are looking for, is a miracle worker, that knows everything about problems, and about all possible medications you are presently taking, plus all the reactions those medications could have to a new prescription he/she may give you. The kind of doctor you are suggesting, is not one I would trust.
They are not using the latest information available to them.
More than one doctor has told me, they are glad that they are not supposed to know everything that is found out by tests, warnings on certain drugs, reactions certain drugs have to one another, and problems they can cause that are not even in their own field. They have said, how much safer practicing medicine today for their patents. They say it cuts down on potential medical mistakes, and malpractice suits.
As the cardiologist surgeon I had been referred to, using the information he had, thought I was in need of a pacemaker (What I had been referred to him for). But when running my current prescriptions given by other doctors in other specialties against my medical problem, it was discovered that one medication could be at fault. A medicine he had no reason to every know about as it was way outside his specialty. Cut that medication by half (the safe dose for anyone), and replacing that half with another medication the problem was solved. No operation.
I and several people I know, would not trust our health to a doctor that relied on his own memory and training for everything. At one time I was a darn good mechanic. I built several hot rods back in the 40s, hopping up motors installing extra carburetors, changing the crankshaft specs., adding a super charger, etc., lowering the frame, chopping the top, etc. Today I would not even attempt to work on a modern car. Doctors not using a computer today, are in my class as mechanics working by guess and by gosh. Mechanics and Modern Doctors, have moved into this century and computers to aid them.
I was retired before the mandate that required EMR. Our practice had so much paper we were drowning in it, and sorting and filing took up a large chunk of our work day.
Test results arrived by mail, by courier, and by doctor when he walked in from his hospital rounds. It went something like this - Alphabetize the papers; pull the corresponding patient charts; open the chart to the "Test Results" section; open the metal posts; file the papers; close the posts; refile the chart. Lather, rinse, repeat with every. sheet. of. paper. that arrived.
Of course, there were times when the filing hadn't caught up with the patients who had appointments that day, which required a frantic search through the filing pile to update the chart before the doctor entered the exam room. Or the paper results hadn't even arrived by the time of the appointment, in which case, the doctor would request that we call and get a fax, stat!
It's a different ball game today, and the doctors I see, (PCP, cardiologist, oncologist) all use the technology as an adjunct, not a replacement for face time. Although that could change with ACA and the influx of new patients that will increase the patient load at your physician's office. I have a feeling it won't be pretty.
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