EMR: Patient Perception
- Mon, 8/8/11 - 1:46pm
- 7 Comments
- 4772 reads
Over the past year, I have had several encounters with physicians using their (very recently implemented) electronic medical record software.
I am not impressed.
My immediate reactions were 1) This is distracting and impersonal, and 2) Hey! I can play this game, too!
With regard to Number 1, here I am, obviously not feeling great, and here you are, playing with your laptop. Once we share the usual pre-work-up pleasantries, you barely look at me, preoccupied/frustrated with the idiosyncrasies of your (albeit new) gadget. I have to wait while you figure out the problems in accessing the proper screens, interrupting my flow of commentary about what is wrong. Thankfully, both physicians eventually set the computer aside for hands-on examination and thorough discussion, but by now I’m feeling a bit off-put. This is not the best situation for a patient who tends to play down symptoms and protect herself, her loved ones, and even sometimes her doctor from having to deal with medical issues.
With regard to Number 2, I feel the EMR can thwart diagnostic thought processes much the same way a calculator removes the need for students to learn their arithmetic facts. I completely appreciate the need for checklists and algorithms. The new system takes away some of the guesswork, I suppose, and ensures that harried clinicians do not miss something. I’m also assuming it provides diagnostic codes as well. But where is the intuition? Where are the clinical assessment skills? What happens if my symptoms don’t fit the menu? Like Mr. Holland and the hesitant clarinet player, I want to pull the sheet music out from under and tell my docs just to “Play the sunset.” You know this stuff. If physicians become too drop-down dependent, this new system seems like a fast track to getting diagnostically rusty.
What’s more disconcerting is my belief that I could reach a pretty accurate diagnosis if I, too, had prompts along the way. This is worse than all the self-diagnosing I do courtesy of webMD. I know, being the editor of this journal and all, that I take more of an interest in things medical than the average person. I am all for the patient-clinician partnership. But there is something to be said for attributing a little more knowledge and authority to my practitioners.
I’m sure EMRs will become commonplace, accepted, and utilized to the best interests of all concerned. But I’m not so enamored right now. Just sayin.’