It is somewhat surprising that in
today's world, with our smart phones, internet savvy and media hype,
when we go to the physician for a check-up many of us tend to sit
back, listen and nod in response to a doctor’s advice on our
conditions or treatments. This does not sound very participatory,
does it? Why does this happen?
It is unfortunate that many patients do
not want to be participatory and even more do not want to be
empowered. On the other side, many doctors do not want empowered or
participatory patients. They have gone to great lengths to confuse
patients and continue their overly paternal ways. They claim they
are doing what is in the best interest of their patients, but in
reality, they often ignore obvious clues and misdiagnose what the
patient presents. They insist on talking at the patient and not with
the patient.
For a prime example of how poorly these
doctors do their medicine, read this blog from Joslin Diabetes
Center. Doctors can be idiots at times and as I read this blog,
those were my exact thoughts.
Two laws are now stepping in and
putting these doctors on notice that they need to provide more to
patients. The legislation that mandated doctors to have electronic
medical records (EMRs) or (EHRs) electronic health records also
mandates them to provide patient portals. This forces doctors
(providers) to more actively engage patients by providing them with
the capability to electronically view, download and transmit relevant
information from their provider’s electronic health records,
including lab test results, a list of current medications, and
hospital discharge instructions. The legislation also requires that
physicians engage in email with patients.
Then we have the latest legislation
that mandates and puts the doctors on notice that they must
communicate with their patients of earn quality points that will
determine their pay structure and incentives. In anticipation of
this and the provisions of the first legislation, these physicians
have developed new terms to muddy the waters and push back.
Meaningful use and patient engagement are the terms these physicians
have invented to work their way around these requirements.
If you are one of the patients that
have been given access to your EMR, then you know what I say is what
happens. When you receive their emails, there are statements as part
of your medical appointment that are not happening. Supposedly, you
have received a pamphlet or page relating to the purpose of your
visit, which you have not received and probably never will receive.
Mine were counseling I supposedly received about weight loss and
another about concern for the purpose of the doctor visit. All the
doctor needs to do is check a box and this is meaningful use when the
paper is said to have been given to you.
Communication is definitely lacking,
but the physicians can claim patient engagement. The theory behind
this patient engagement is that when we have access to our medical
information and we are assisted to the point that we understand what
our care is all about, we will respond positively to our treatment
options and take better care of ourselves. If this communication
actually happened, I would be very happy. Instead, I have needed to
go to the computer and research to find information about the problem
that I saw the doctor to communicate with on the topic.
I will admit that some doctors are
actually communicating and rebuilding the doctor-patient trust, but
most doctors are not. I have blogged about some of this on 28 and 29
December 2013. Another good blog by Nancy Finn about what is
supposed to be happening is a blog you should read and become
familiar with because it does explain some items I have not covered
in this blog. She does explain patient-centered better than I do and
probably because I have not seen patient-centered benefits at this
time.
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