Value to Talking?
It turns out there is value to talking to patients. Who would have thunk it? In this article Place More Value on Talking with Patients, Experts Say I found this quote intriguing:
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Paying doctors more for simply sitting and talking with their patients — rather than basing payment more on quality measures — would be a great way to improve the doctor-patient relationship, Andy Lazris, MD, said here Tuesday
Anyone else smirking after you read how quality measures are failing? I know I do. I just can’t stand it when doctors are surprised by this. YOU WERE WARNED! Stop complaining about it.
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The blame, of course, will be placed on the doctors. Why do doctors spend so much time looking and clicking, not listening?
The great anti-human movement of the 21st century rolls along. If something fails, it is human error. The machine is infallible. Dying societies often have idiotic superstitions to comfort their fall.
The idea that IT and medical records will save us, because they are infallible, that’s sad stuff.
The standard for medical opinion used to defer to the conclusions of the doctor who has SEEN AND EXAMINED THE PATIENT. Even in Grand Rounds, talking to the expert in the disease process, the attending had deference. Consultants offered IMPRESSIONS AND SUGGESTIONS. the center of the decision process was that one attending.
The new way is to have pre-programmed answers to questions before they ask. Every decision point in an algorithm constitutes an opinion. Frequently, it is a decision made by a programmer or committee of the uninformed, who have never been to the bedside.
I have been dinged for “too long” or “too short” a course of antibiotics. IT specialists NEVER give a rule for antibiotics. Treat until it is safe to stop. There is no magic for the number of days for a UTI. But the programmers think so.
“Paying doctors more for simply sitting and talking with their patients…” That’s a naive perspective. The history and the physical constitute the center of diagnosis and treatment. All information should flow to the one human mind who will coordinate their care.
In a battle, generals simply sit and talk to their subordinates. But the subordinates only inform; the general acts, and doesn’t care about anyone else’s opinion. That wins wars.
We don’t do it by putting it all on an app, or having committees of tank movements, citing the rules; submission of requests to use infantry, or air power. That’s how medicine is run, and why we are losing.
I am now taking my “Cultural Competency” course put on by HHS to help fulfill my requirements for MoC (yippee). Of all the problems with supposed cultural issues, many of these concerns could be solved just by having more time with the patient. I also find it laughable when they talk about docs compromising with someone’s beliefs in traditional or herbal medicine, while we are held to medical malpractice standards and quality measures at the same time.