A long-standing pillar of medical care—the relationship between patient and healer—is today under siege. Ongoing maneuverings in the health care industry sabotage this critical connection and undermine its value. This bond has been strained by the ever-present dollar, marketing ploys, narrow networks of providers, unrealistic expectations, and the electronic health record (EHR).
The EHR has especially fractured the in-office interaction between physicians and patients. It diverts attention away from what the patient has to say by requiring providers to constantly record patients’ symptoms as digital entries on a computer screen. The patient chart becomes a bloated digital file stuffed with medical facts obtained from earlier visits and cut-and-pasted forward in order to fend off auditors from any electronic fraud accusations. Much of this electronic data provides little contribution to the care of the patient and may cause the doctor to ignore pertinent information.
Family physicians, pediatricians, internists, gynecologists, ER doctors – the primary care providers who serve in the trenches of everyday human maladies – are routinely drawn away from the precious art of medicine involved with face-to-face patient care. Physicians are forced to adapt to their new role as electronic scribes and put the patient’s interests aside, at least temporarily. Instead of conducting a concise review of patient data – current medications, allergies, past surgeries and illnesses- and then moving on to the patient’s concerns, the doctor is saddled with thousands of digital particulars and a multitude of useless computerized documents, which require endless clicks and screens to find even one morsel of relevant information. How does a patient matter in such a scenario?
The bond between patient and provider has devolved into a corporatized transaction with industry controllers fixated on market share and profit. The tender aspects of patient complaints and fears hold little sway and gain little notice. Narrow networks and EHR’s particularly govern and control the manner in which physicians attend to their patients, and the “who, what, where, when, and how” medical care will be received are no longer questions for a mere patient to decide.
The new paradigm of one size-fits-all treatment is a demanding taskmaster and ongoing audits are used by insurance companies and “big brother government” to determine patient needs. How does a patient matter in this scheme of things?
And so questions remain… for at least a little while longer.
1. Is it already too late for patients and physicians to rise and up and declare that one size does not fit all in the very personal matter of an individual’s health?
2. Must personalized medical care give way to a factory metaphor of widgets and assembly-line laborers?
3. Do we have the guts to declare that the real cost of primary care narrow networks and EHR’s goes far beyond dollars?… that it compromises patients’ ability to receive candid and meaningful guidance…that it blurs the critical responsibility of doctors to tailor their recommendations to each patient’s individual needs?
If we fail to personalize care, we put the health of our patients at risk and compromise the high quality of care that our state is renowned for. We must find alternatives to a cookie-cutter plan of care systematized by industry giants by allowing patients to choose the primary care physician they trust.
And let us not insult our patients – they understand that trust is built when physicians champion their needs and advocate for their wellbeing by focusing on mind, body, and spirit – the whole patient!
