Medical Practice and Technology: What No One is Talking About
We now live in a time where humans are most interconnected than they have ever been. Contact can be made between individuals, in the form of text, audio, video or all simultaneously from various points around the globe. This instant communication has dramatically improved access for communication, yet the irony remains:
… the quality of interpersonal relationships has plummeted drastically. This is what no one is talking about.
What was once the hallmark of clinical medicine, the privileged relationship between doctor and patient; its integrity has been violated by the commodification of health perpetuated by insurance companies whose effects trickle down to hospitals, private practice, and the patient themselves. This issue is further compounded by the increasing amount of individuals in need of health care. The billing and proper coding of said visits in order for reimbursement, as well as the increasing services exchanged mode of life of the 21st century where individuals are no longer treated as individuals but are just the medium or face for any given exchange.
What does this mean for physicians?
For physicians, this means a max of fifteen minutes facetime as per Medicare guidelines decided upon in 1992. 26 Years Ago. Of that fifteen minutes, of that time a little over half or eight minutes is spent actually talking to or examining the patient. During that fifteen minutes, five minutes is spent on administrative (read coding and billing) tasks. For physicians, medical practice becomes an assembly line. As Terrence Holt states in his novel Internal Medicine, “Any patient in a hospital, when we take their clothes away and lay them in a bed, starts to lose identity; after a few days, they all start to merge into a single passive body, distinguishable … only by the illnesses that brought them there.”
Patients losing Patience
Consequently, patients are becoming increasingly frustrated with their physicians. Waiting ten, twenty, thirty minutes plus just to exchange pleasantries and be shooed out the door. No differentiation made between the 27 year old woman, or the geriatric 72 year old because time no longer allows the fostering of an actual relationship. Furthermore, financial anxiety, ever changing insurance plans and what is and is not accepted on all ends further sours moods. For humanity in general, there is a need for basic acknowledgment. Technology can assist in this area by allowing some semblance of connection between doctor and patient, but as always time is the biggest factor.
The modern nature of medicine has physicians feeling burnout. A much more serious “senioritis” as felt by upcoming high school and college graduates. Physicians suffer a loss of enthusiasm for their work, increased feelings of cynicism and low feelings of personal accomplishment. The four factors for burnout are time pressure, degree of control, work pace and level of chaos, and alignment of values between physician and administration. Consequently, these factors also are key components to the degradation of the doctor patient relationship. The top causes of burnout are bureaucratic tasks, spending too much time at work, increased computerization, and “feeling like a cog in a wheel”. Physicians today spend half of their time on administrative tasks compared to a quarter of their time with patients, a significant contributor to said burnout. This burnout produces increased medical errors, less emphatic and more stressed physicians who “take it out” on their patients due to the “assembly line”, lower patient compliance and reduced favorable outcomes. For some sadly, the only way to escape this burnout is to commit suicide. With increasing legal complexity of medicine, the penalties of making said mistakes, and an increase in administrative workload, the bureaucracy and commoditization of healthcare is something prospective physicians oft do not think about.
Despite the abundance of technology in our lives today, for some reason its presence has pervaded the healthcare sector the least. Physician offices and hospitals still use whiteboards and outdated (or current yet useless) software, while Siri, Cortana and Alexa can have a pizza delivered to my location by voice. Poor quality tech further erodes doctor patient relationships, increases physician burnout and is significant cause of loss of revenue. Technology should make life easier, and inefficient EMR platforms do anything but.
This is what we think about when we work to improve DocCharge. At the end of the day, we want our partners to feel more control of their time. Because time needs to be spent where time is mattered the most.