Perhaps, as never before, the medical establishment is transforming, facing both challenges and benefits. Case in point: electronic medical records. These hold the promise of being able to track health conditions more effectively, but at what cost to the patient-physician relationship if the doctor spends the visit typing on a keyboard?
The American College of Physicians, the national organization of internists, has been on the front lines of issues from EMRs to climate change, gun violence, insurance and the cost of prescription drugs.
Its newly named executive vice president and CEO as of this September is Darilyn Moyer, a Temple University professor of medicine who holds several leadership positions at the Lewis Katz School of Medicine.
She recently spoke about some key issues facing internists and their patients.
What can you tell us about the high cost of prescription drugs?
This is an issue that is alarming everyone, regardless of political leanings. Patients are unable to afford medication, particularly for some of the newer therapies – the cancer drugs, the hepatitis C drugs. We’re seeing an escalation in prices of drugs that have been on the market for a long time.
This is a vital issue that is affecting our patients every day. And it’s affecting the primacy of the physician-patient relationship. We want to get back to having more face time with our patients rather than spending time on the phone with the insurance companies, with the pharmacy benefit managers. Patients are being asked to pay a lot of out-of-pocket costs. There is a complicated system of patient vouchers and co-payments. If we were able to negotiate more reasonable drug prices from the get-go, there wouldn’t be more of these hoops for patients and offices to go through to get the medications that patients need.
I was at a medical conference recently, and one of the keynote speakers showed a video. It was of a boy, 7 or 8 years old, sitting on a sofa, staring at a computer screen, clicking on a keyboard, not breaking his vision at all. Peering around the corner were his parents, who were just beaming. One of them said to the other, “Oh look, he wants to be a doctor.”
There are wonderful benefits of having electronic health records. However, we really want to get more usable health information technology systems. Less clicking. A recent study found that in a 12-hour shift in an emergency room, a physician in training had to make a click several thousand times.
That’s resulting, quite frankly, in an epidemic of professional dissatisfaction in the medical community. We want doctors to be satisfied because that results in better care for their patients. Happier doctors who are professionally satisfied are more engaged.
We’re trying to reinvigorate the patient-physician relationship by challenging unnecessary practice burdens.
philly.com
June 18, 2016
There are a lot of downsides to EHR(and a few upsides); one is the lack of eye contact, and that docs are fixated on their screen…The use of “scribes” is a good idea, catching on…..it frees up the doc, and input is more accurate……
My husband needed to go to the ER at Tucson Medical Center about a year ago. The Dr. he saw was accompanied by a “Scribe”. She followed the Dr. and entered all the information and conversation between the patient and Dr. I am not sure if it was some kind of trial because we have been back to the TMC ER and I have not seen another scribe. I think it is a great idea but probably very costly.
As a patient I would like to have the doctor look at me when talking about my health rather than typing away into a computer. Even turning from conversation with me to then typing into the computer gets in the way of an interaction where not only my words are being considered, but probably more importantly is what my body is conveying during the discussion. Who is the patient in the room? Maybe it is the computer because that gets most of the attention. But the one who pays the bill is me. So as not to completely whine, I appreciate it when I go to another doctor in the practice who can pull up my record and get a rundown of my meds and allergies at a glance.