I always snicker at that Ally Bank commercial in which a human at a dry cleaner’s business is replaced with a blender. It sounds absurd, doesn’t it? And yet, we’ve all had it happen to us in one way or another. You’ve likely called “Customer Service” and were sent on a finger-fumbling journey through menu after menu, only to be either placed on hold or disconnected. Or maybe you were asked to speak your choices from the oh-so-friendly-sounding automated voice cooing choices in your ear: “Press 1 for technical support. Press 2 for account information. If you know your party’s 27-digit extension, enter it now. Please wait while I try that extension.” Don’t you feel silly talking to a machine?
Unfortunately, we’ve come to expect such detached treatment from many service industries. But think about this: Could it be that your doctor is being (has been?) replaced by a machine? Have you seen your doctor lately? If you have, chances are he or she came into the room clutching a wonderful, magical machine. No, it’s not a blood pressure monitor, EKG machine or defibrillator. It’s a tablet or small notebook computer. And chances are good also that he made more eye contact with that tablet computer in his hands than he did with you.
Thanks to electronic medical records, doctors have been forced to become one with their computers now. When Dr. Peter J. Papadakos, an anesthesiologist and director of critical care at the University of Rochester Medical Center, wrote about these electronic distractions over two years ago, he correctly predicted the future when he said “it’s getting worse.” While it’s true that those electronic gadgets contain a wealth of information that might be helpful in assessing a patient’s condition and improving patient outcomes, it may be that the doctor is relying too heavily on the gadget instead of the human sitting right in front of him for very real, very personal, very important cues about the patient’s illness. After all, the gadget is not the patient: the patient is the patient.
In an effort to help physicians engage their patients in the whole electronic extravaganza that is the patient encounter, Kaiser Permanente has developed the LEVEL system for paying attention to a patient while in the exam room:
L: Let the patient look on
E: Eye contact
V: Value the computer
E: Explain what you’re doing
L: Log off
This is supposed to send the message to the patient (and reaffirm to the physician) that “the computer is our friend!” So now, not only does the doctor have to remember how to navigate through drop-down boxes, menus, medication interaction sections, diagnosis codes and such, he also has to be retrained to make eye contact with the patient. Do patients really care about the computer that’s in my doctor’s hand or what he’s doing with it? I don’t think so. I think a patient just wants to be heard and seen. That requires the doctor’s full attention, and no nemonic system is ever going to replace good old fashioned one-on-one conversation and eye contact.
Dictating part of the patient encounter allows the doctor and patient to interact much more natural and personal way. Instead of the doctor trying to type into the appropriate fields what the patient is conveying, he can instead just dictate it in a much more clear and detailed way than his data entry will allow. If you’re a doctor struggling to find a balance between computer interaction and patient interaction, call us and together we’ll work to implement a system of dictation and transcription that suits the way you want and need to practice medicine.
Bumgarner Transcription and EMR Integration — 864-905-3559.