Will Information Technology Squeeze Physicians Out Of Their Central Role In Health Care?

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Not by a long shot if patients have anything to say about it.

Turns out that while most of us (90%) would like be able to make a doctor’s appointment and check lab results online….85% of us also still want the option of be able to talk to our physician face-to-face.  These are the finding from a recent 2012 study conducted by Accenture.

These finding will no doubt come as a surprise to many of those high tech newcomers to health care looking to make physician and trips to the doctor’s office a thing of the past with some new “killer health app.” You wouldn’t believe how little many of these software and app developers know about how health care works.  Then again, if you have looked at some of the EMRs, PHRs, and patient portals solutions being hyped out there maybe you could believe it.

What is significant about the finding cited above is that patients at least get it.  They understand the value of a having a relationship with a knowledgeable physician or similar health care provider.  In spite of, and for some, because of the plethora of health information outlets on the web people want to know that they always have access to your family doc when the chips are down.

What newbie software engineers and  smart phone app developers fail to understand is that health care is fundamentally about social interactions…not technical data transactions like depositing a check or making an airline reservation.

Here’s what I mean…based upon some 20+ years working in health care:

  • From the get go…going back to Hippocrates…health and health care delivery has been about the relationships between people starting with the  physician-patient.relationship.
  • The most important diagnostic tool a physician has at their disposal is not a smart phone…but their ability to talk with and observe  patients verbal and non-verbal behavior.
  •  “Talk” is not only how physicians diagnose problems and recommend the appropriate treatments…talk is also how patients are able to engage in the health care.  Perhaps the most overlooked aspect of talk (and touch) during the medical exam is the therapeutic benefits patients derive from being able to express heart-felt fears and concerns to someone who hopefully cares.

 

The unfulfilled promises of so much of health information technology today (like Electronic Medical Records, Personal Health Records, and Patient Portals), with some notable exceptions like Kaiser, Group Health and the VA, can be traced directly back to developers not understanding that their job is to enable physician-patient relationships not get in their way or try and replace them.

Check out this related post – Patient Engagement Is A Physician-Patient Communication Challenge…Not A Health Information Technology Challenge

I don’t consider myself a Luddite when it comes to health information technology…nor would I put most physicians in this category.  The health industry is going through massive change, and unfortunately in such time, there is also a lot of false starts and waste that comes from ill conceived HIT solutions.  I suspect that tech vendors that take the time to learn the business that is health care, and commit themselves to improving the physician-patient relationship…will do just fine.

 The Take Away…

The physician-patient relationship remains paramount for us patients.  Yes there are problems…yes physicians and patient need to learn to do a better job communicating with one another.  But when everything is said and done…when the chips are down…we don’t want to be forced to diagnose and treat ourselves.  We want to be able to see and talk with our doctor when we want.  And honoring the patient’s perspective after all is what patient-centered care is all about right?

And oh by the way…we still want the convenience of being able to go online to schedule an appointment and check out lab tests.

That’s my opinion…what’s yours?

Sources:

Squeezing out the doctor -The role of physicians at the center of health care is under pressure.  The Economist. June 2012.

Could mobile apps replace doctors?  KevinMD.com

 

7 Comments

  1. [...] Not by a long shot if patients have anything to say about it. Turns out that while most of us (90%) would like be able to make a doctor’s appointment and check lab results online….85% of us also st…  [...]

  2. joeketcherside says:

    This is SO right on. I am a strong advocate of letting patients have access to their health information at all times, to new results as soon as they are complete, to view the entire physician record, to information about best practices for management of their conditions and to communicate securely with the physician and his staff. Why? So the patient can engage WITH their physician and be better, more knowledgeable, more active and more successful managing their health. Done well, information technology will cement the central role of the physician in healthcare.

    We do value the human interactions with others. Done well, health IT will supplement this by extending our communication and connection with our doctor and not by replacing it.

  3. Frankie Li says:

    Maybe the use of Telemonitoring for the bio metrics (B/P; weight, Pulse Ox, Glucose monitoring, via Bluetooth technology via a web based dashboard process) would be more effective than the visit to the PCP office. Recently, we ran a pilot program with 20 patients who were labeled “non-compliant’ because they did not want to go into the PCP offices. We placed them on Telemonitoring for 90 days and the results were great. They were not non-complaint, just did not want to be tied to the PCP/SPC offices. With the portable equipment that was easy to carry with them, they were mobile and able to be empowered and actively making decisions on how they managed their healthcare issues. It reduced admissions and ER utilization on these patients. It also allowed them to be as mobile as they wished, while allowing the PCP/SPC or even their loved ones access to their biometric information and having those providers and Case Managers to intervene in the moment, when the parameters set were out of bounds. Is this the answer to the above problem, alone, NO, it will need to be the holistic care of the patients, that includes this type of technology, along with healthcare providers, patient, and their loved ones. Thoughts?

  4. I think the study you descried is a great use of technology in an appropriate situation. I suspect that over the course of the study, the participants became more trusting/comfortable/satisfied with having a closer relationship with their treating physician…which is the main thing.

    It would be interesting to know more about why the patients in the study were reluctant to get in to see their doctor face to face.

    Thanks for your comments and sharing.

  5. Bern Terry says:

    Some technology helps, not hurts interactive face time. The gold standars is still MD at bedside. But sometimes the right MD is not available, and in those cases, technology like VGo is not replacing any clinicians, but extending access to care, and enhancing MD/PT communications. It is more telehealth than telemedicine. MD’s we work with say they have the data they need for diagnosis and care planning, and more than 50% of their work is linking PT data to that observation and consulting, counseling, communicating, educating patients. www. vgocom.com

    • Bern,

      I happened to see the ABC News broadcast about your “virtual” person product. Very cool! I totally agree that technology has its role and can enhance the physician-patient relationship if applied intelligently. Good luck!

      Steve Wilkins

  6. Mark says:

    Stephen, technology can definitely help. A computer in your pocket that is more powerful than mainframes that took up entire rooms most a few decades ago can be used to help people take responsibility for their own health, the doctor isn’t with me every moment of every day, the computer in my pocket is.

    It does no good for our societies struggles to turn the corner on health for any of us to belittle the work or motivation of these “newbie software engineers and smart phone app developers”

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