When you’re sick, you face formidable problems. You don ‘t feel well, you’re in an emotional turmoil, you can’t think straight. To make matters worse, when the physician is taking a medical history and physical exam either in his office or in the hospital, he has his back to you most of the visit while he looks at the computer. The electronic medical record has shifted focus of the physician’s attention on the computer rather than you, the patient.
Michele Ross is fed up with the lack of doctors’ personal skills. She receives her healthcare at a clinic and sees a different doctor each time. “Many of the doctors just sit behind the laptop, don’t make eye contact, and even forget to physically examine me when I complain of something,” says Ms. Ross. “The whole point of a doctor visit is physical interaction. Otherwise, I’d just use telemedicine. I’m an educated woman and can use the Internet to self-diagnose. I depend on the doctor to use his judgment to confirm what is wrong and the best way to treat. Laptops and tablets should be banned from use during visits.”
According to a 2014 Northwestern University study published in the International Journal of Medical Informatics, doctors who use electronic health records in the exam room spend about a third of their visits looking at a computer screen.
“My worry has been for some years that the patient has become a mere icon…the real patient is in the computer,” says Abraham Verghese, M.D Verghese, the best-selling author of the book Cutting for Stone and a professor in the Department of Medicine at Stanford University).
“I’ve actually coined a term for that entity in the computer–I call it the I-patient. Like your I-phone or your I-pad. The I-patient gets wonderful care all across America. The real patient often wonders, ‘Where in hell is everyone? When are they going to tell me anything? What’s going on?’”
Mr. Verghese believes physicians have been railroaded into a kind of care that’s very technological, very expensive, and very unsatisfactory.
Carole Leiberman, a Beverly Hills psychiatrist, argues doctors have become slaves to insurance companies and Obamacare, which require more bureaucratic paperwork than ever, causing more clicking than caring.
“Technology has done more to ruin health care than to improve it,” says Ms. Lieberman. “The close doctor-patient relationship, necessary for proper diagnosis and treatment, has become a distant doctor-computer-patient relationship. The friendly old family doctor, who once made house calls, has been replaced by a cold computer-obsessed doctor who doesn’t even make eye contact. If a patient doesn’t feel a connection to his doctor that encourages him to confide, and the doctor doesn’t have time to ask enough questions about the patient’s lifestyle, symptoms, and so on, then the proper diagnosis can’t be made, and the proper treatment can’t be prescribed.”
Despite that dire diagnosis, Mr. Verghese is optimistic. He sees that the young people who are going into medicine today are much more idealistic and they want to try to change the system. “I am delighted that those who are going into medicine are doing so for the right reasons,” he says. They recognize that if it’s money they want to make, there are better ways to do that.
Mr. Verghese hopes the pendulum will swing back to the way it should be. “To me medicine is timeless and unchanging. The patient/physician relationship is sacred and unchanging,” he says. “The unfortunate things that are happening in medicine will never alter the fundamental values of medicine.”
Michael Murphy, MD, CEO of ScribeAmerica, is banking on the premise that scribes, who collect and enter data, will be an essential part of our future healthcare team. “Doctors can’t continue to be data-entry clerks as it is hurting patient care and doctor/patient relationships,” says Mr. Murphy. “At the end of the day, medical scribes are going to be the standard in healthcare and they will be part of the team: a physician, nurse, tech, and a medical scribe. As the EMR, federal, and insurance regulations continue to impact physician productivity, the need for assisted documentation will grow.”