YOUR DOCTOR VISIT
A one-size-fits-all approach to medicine will not work. Have you recently gone to your doctor and noticed some changes? His waiting room is now a reception area. He is very concerned in cutting down the cycle time of you the patient, and you are limited to 7 minutes with him. In the past he was reimbursed for his time and expertise, but now non-traditional visits are handled by phone consultations, smart phones, e-mail, or video chats. The offices want your registration forms completed by way of mail or computer to have everything available when you come. If you require 15 minutes or more, you will put you in slots where he is not busy. His practice is now being called “patient centered medicine” that primary care medicine.
His usual jovial personality has changed, and you no longer can engage in meaningful conversation about you, your health, nor even the state of Obama care. He asks the questions, and you answer yes or no.
When your doctor enters the room, he is now carrying a laptop computer. Sometimes he will put it on his lap, but soon notices that the heat may fry his testicles, and puts the computer on the counter.
All the information you’re giving him seems overwhelming to him as he mutters under his breath and begins typing. He no longer is looking at you, but remains focused on the computer data he must place in the registry. Your visit ends, with your wondering: “How on earth can he know what to do for me.”
Charting has become more important than providing a quality experience or quality outcome with you, the patient. Your doctor is forced to do this, because of several new payment schemes, with names like “ accountable care organizations”, “global payments”, and “ and bundled payments”, all of which are already in their pilots stages in Massachusetts, Michigan and California. The programs all aim for the same result: CAPITATION ( another name for the old HMO). To make all this work requires a great deal of technological infrastructure. So dear patient: Your doctor in order to play the game, he must pay the price.
The electronic health records (EHR) certainly has benefits. It signal potential drug reactions, makes prescriptions and notes more legible, and eliminates storing paper charts. The data however is very slow and cumbersome, Reading it is very difficult, as your doctor sifts through meaningless data trying to find your important information that he needs to treat you properly.
It is also very expensive. In a mid-sized practice, we are talking hundreds of thousands of dollars for the hardware and software just to get started. This does not count the huge annual service charges each month. In the face of getting lower reimbursements for your care, and his rising costs of private practice, many doctors are abandoning their practices and joining hospital groups. Your next visit may no longer be with your doctor, but his surrogate, or a nurse physician’s aid.
The new health reform bill, called Obama’s Patient Protection and Affordable Care Act. Is now a law. The reform bill provides incentives for doctors and hospitals to do less for you in terms of treatment and diagnosis, and to do more for the government by providing cost-saving data To provide more quantity and less quality . The meaningful use criteria for EHR. Is all framed as: “ quality health improvement”.
Certainly the technology industry has a lot to gain. The dollars for your patient care are now being diverted into the pockets of Silicone Valley, the makers of computers and software. Follow the money trail, and you’ll see who has the ear of Congress.
These new payment schemes and the EHR that supports it, penalizes your doctor when he interprets your medical findings properly and tries to customize a treatment plan that will work for you.
I think that you the patients still sees value in quality, individualized care, patient centered care, and compassionate care. Hopefully you realize a one-size-fits-all approach to medicine will not work. Regardless, get ready for more big changes in the way your doctor practices medicine.
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