Technology won’t Fill the Deficit Unless Docs Bring Knowledge and Caring to the Table

As anyone who has been around PrimeCare of Wixom from the beginning knows, we are no stranger to technology. When we started in 1999 we were one of the first if not thefirst, Family Medicine practices in Oakland County to go “electronic”.  I could see back then that this was the way it was going to go and pushed for early adoption of the technology.  Certainly our electronic medical record (EMR) has enabled us to provide superior care over the years in a way that is not possible with old paper records.

Now, with the recent mandates by the government that practices adopt EMRs, “or else” suffer financial consequences, the use of this technology is becoming ubiquitous.  Those that cannot adapt to the new reality will become extinct.  It is a mixed blessing.

When I teach the residents, it is my contention that how records are kept is immaterial. Records could be in a shoebox for all I care IF the doctor could easily pull a list of all the patients who were ever prescribed a medication that just received a “black box” warning.  Or IF a list of all patients overdue for a significant screening test could easily be used to reach out to those patients.  Our mature EMR can certainly do that and with minimal “human” intervention, although we invest considerable time, money and personnel time, into making sure that our outreach efforts are done appropriately.  But I do not believe that this is the “care” that our patients have come to expect or even desire.

The role of the primary care doctor is about to change dramatically with the availability of “real-time data” via  smart phones.  Patients of the immediate future will “know their numbers.”  They won’t have to come to the doctor to find out what their sugar, cholesterol or oxygen levels are.  Their phone will give them real-time displays of this data and even more – how much REM sleep did the patient get?, what is the BP doing in response to caffeine?, etc.  This will enable those that are motivated to make much better choices about the thousands of little things that lead to big changes in overall health.

The doctor of the future will have one of four roles.  He will either be a doctor’s doctor   (a radiologist,  pathologist, etc.), a technician (i.e., a surgeon), a diagnostician (like myself, putting information together to formulate a diagnosis and plan), or a motivator (getting the patient to actually implement the health care measures we have learned are effective at improving health.)

For the diagnosticians, the role of computers will certainly help, but it won’t be enough.  It will be even more important that the clinician be able to look into his patient’s eyes, close up the laptop, and begin, “OK.  I see something has happened to you.  Tell me what’s wrong.”

There is an old saying in medicine that patients don’t care about how much the doctor knows until they know who much the doctor cares. While knowledge is important, this has probably never been truer.  Technology can make a good doctor better.  But it takes a whole team of caring individuals who are united around the single goal of serving the patients for whom they care, that the best care, the most effective and  satisfying care will be achieved.

TWS  — Wixom

03/17/13