Technology conjures images of steel and gadgets. Parts and pieces. Bells and whistles. It’s sophisticated. Intriguing. High tech. But it’s, well…cold and impersonal. Or is it? Many of us have witnessed firsthand the things that distance patients from doctors. Status. Knowledge. Jargon. Peculiar equipment. Rushed visits. Should we add technology to the mix?
A few short years ago, some health experts refuted efforts designed to progress the use of technology in healthcare. They insisted that technology would distance patients from doctors, who would increase their focus on “dissecting” and “diseases” rather than “emotional connection” and the well-being of their patients. Yet, recent reports have focused on the converse: how technology is bridging the doctor-patient gap, rather than widening it.
Convenience
The most obvious benefit to using technology in healthcare is convenience. With progressive electronic medical records, physicians, referral sources, and diagnosticians can share data with ease and speed, thus enhancing and expediting patient care. Patients can also view their own test results, refill prescriptions and send and receive messages from key healthcare professionals, in as close to real-time as possible. In today’s high-speed living, this benefit remains apparent and immeasurable.
Transparency
Google makes finding answers to almost anything possible. While doing solo searches may not glean the most accurate or comprehensive information, most people can grasp the basics when they dedicate time and energy to learning about a condition or a treatment.
Technology also assists patients to research doctors, practices, hospitals and centers in order to determine a good fit. Although not always reliable sources of information for upstanding physicians (there will always be a customer who is dissatisfied and who will be more likely to write negative online reviews), reviews of truly unethical practices will clearly stand out. With such visibility, patients can make informed decisions about their care. Of course, this can backfire. Perpetual “doctor shopping” can become a deterrent to good health. A 2010 study noted that patients who had a consistent relationship with a single physician experienced both better health and better satisfaction with their care than those who didn’t. And a recent Consumer Reports survey stated that 76 percent of primary-care physicians surveyed said that establishing a long-term relationship with a doctor is the most important factor for patients to receive better medical care. Yet, online quality searches offer a good starting point for patients.
With technology, the trend has been to become your own advocate, and patients have grown an interest in understanding their health. With advanced technology, patients themselves can experience their conditions firsthand. This often enhances buy-in and follow-through on physician recommendations. In one study, cardiac patients who had the opportunity to see their heart scans were more likely to follow recommendations to reduce their risk, such as losing weight.
The Changing Role of Physician
The advent of technology in healthcare in recent years has extended beyond the one-way measures designed for patient and professional convenience, like electronic charting, e-scripts and looking up test results. Now, patients, themselves, can do their research online, unearth information from consumer-driven TV marketing, and use apps designed to track, treat and prevent ill health. This has shifted the physician role to one of interpreter, advisor, and coach. Dr. Robert Rowley, a family practice physician in Hayward recently wrote, “Patients, when they come to the doctor seeking health care, aren’t necessarily looking for ‘raw data’ – they have already looked it up online. Instead, they are looking for meaning.” This role shift severs the patriarchal, hierarchical, authoritative relationship that physicians have traditionally had (or were perceived to have had) with their patients. And that’s a good thing. While doctors will retain the utmost expert medical understanding due to their training and extensive experience, with a more collaborative approach comes the patient’s vested interest in their well-being. This can only serve to improve the health of many.
Personalized Care
When all is said and done, what really matters to any human—physician, patient or otherwise—is that they mean something and that they are treated with respect and dignity. Treating people like objects in any relationship—employer/employee, husband/wife, or patient/doctor—never works. We get ourselves into trouble any time we view people as objects, as means to an end–patient appointments as a means to pay overhead; a sensitive prognosis discussion or phone call as a deterrent to catching up and leaving on time. Yes, we need limits. But not cold and harsh ones. Technology, especially social media and videography, within the confines of ethics, has broken down barriers to allow doctors to see patients as people (and vice versa, to a limited degree) and to celebrate them as such. It’s hard to ignore or forget a post about a new baby, a move, or a family death. While the realities of running an efficient practice can’t be ignored, people certainly can’t.
Technology, it seems, is a winner. It’s here to stay. After all, people across the world connect with Google and Skype, navigation bars and Tweeting. Let’s use it to our patients’ advantage, in “service of humanity… with conscience and dignity.”
Resources:
- http://www.msnbc.msn.com/id/41809130/ns/health-health_care/t/better-health-doctor-patient-relationships-improving/#.UDby99ZlRyw
- http://blogs.kqed.org/stateofhealth/2012/04/19/technology-enables-collaborative-doctor-patient-relationships/
- http://www.yaledailynews.com/news/2010/oct/22/technology-destroys-doctor-patient-relationships/
Diane Dean, RN-BC, LPC, CEG is a licensed registered nurse, a professional counselor and a professionally-trained coach with 20+ years of healthcare experience. She owns and operates Epiphany! Counseling and Wellness Center in Pittsburgh, PA and works as a writer for healthline.com
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Great insights, and that’s exactly what I’m seeing as a clinical oncologist. We’re moving out of centuries of a “unidirectional” model in which doctors, who had a monopoly on relevant information, told patients what to do, to a new era of “bidirectional”, collaborative care that also includes input from online communities and leads to a mutual discussion of how to best proceed. In the world of cancer, at least, progress has been so fast that no single doctor can know everything that might be relevant to a patient’s care, and it is a disease that is typically very serious but also often chronic enough that patients and caregivers can have the opportunity to become quite educated and participate in their own care. This creates an ideal setting in which doctors should welcome additional input from patients and caregivers who can become very sophisticated allies in generating the most overall knowledge and, ideally, a consensus about the best treatment strategy.
I think the leading challenges are that it takes time and effort for patients and caregivers to really learn the nuances of a topic, that it can be difficult to assess the quality of a very wide range of content available on line, but especially that this new model challenges our conditioned expectations. Doctors have expected to be the definitive authority, and acknowledging that they can’t and don’t know everything relevant about a subject undermines outdated but longstanding presumptions of what a doctor should be. It represents a fundamental change in the identity of what being a doctor is, at least among doctors who trained before Google and online communities democratized health care information.
Meanwhile, patients and caregivers can no longer cling to the idea that it must be a terrible shortcoming of their doctor to not know everything about their medical issue. That concept is predicated on a fiction perpetuated by the health care system and the media, but it’s important that knowledgeable patients who do collaborate in bringing new information into the exam room don’t presume that only a sub-par doctor would benefit from the insights collected by people who can focus on a single case — their own — with intense focus. Even the most knowledgeable doctors will need to spread their attention across a range of patients and conditions.
There’s no question that the democratization of medical information has been disruptive, and I strongly believe it will prove to be beneficial, but it is always difficult to have new conditions overturn longstanding social dynamics.
Jack West, MD
Seattle, WA
Thanks Jack… I’ve always felt that docs should never be afraid to say ” I don’t know” … but let’s head to the computer and find out. I also think it’s perfectly ok to give patients homework — and the appropriate terms to search and then have them return in a week of so to review what we both learned.
Howard Luks, MD
Hawthorne NY