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Monday, January 11. 2021
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Off topic of the article above, but in the past 5 years any time I needed MY records to go to a new primary care practitioner, or from a specialist to a PCP, the computer printouts were scanned badly and transmitted by fax.
New doc finds it incredibly frustrating that they aren't searchable, and in fact can hardly be called legible -- in spite of originating entirely on computers.
My efforts to get a better version from the old practice have been like talking to a brick wall from my perspective. So my experience of electronic records is both that they take away from my feeling that the Doc understands why I'm there, AND that they detract from medical professionals communicating between themselves what is important for my care.
Back on-topic - I tried a chiropractor (who also did aromatherapy) for relief from pain. I was very turned off by this individual, as I suspected that the pain was a temporary problem (it was) but the treatment 'plan' was looking like a lifetime commitment.
The experience of being in the aromatherapy/chiropractic office did give me some insight in to the popularity of alternative medicine, however. They made a good show of attentive listening, and whenever someone came through the waiting room door they were immediately the top priority of someone from the practice.
Thinking on the inutility of the electronic notes: Too much information with too much detail that is in general almost entirely irrelevant.
Having shared houses/apartments with MD/PhD students and Med School professors, I can see how the records make their research WAY easier, however.
Absolutely agree with the piece. Checkbox medicine vs thinking through the problem. But EMRs benefit bean counters and medicrats, not patients or doctors.
There's a lot to what you say here. It's maddening to see a doctor in the examination room, you're sitting on the table, he's hunched over his laptop, peppering you with questions - without taking his eyes off the screen.
After a few notable incidents taking care of my mom, and a personal medical incident a couple of years ago, I now keep a complete medical file of my own and walk with it whenever I have a visit. It's maddening how often these inter-office records transfers become dropped balls - and you can get all the way to an appointment before you find out they didn't get what they need to proceed. Having it in my hand ensures it all goes smoothly and also gives me something to review, research, and ask questions about.
Speaking of medical: "Bonnie Watson Coleman: House Democrat blames Covid diagnosis on lawmakers who didn't wear masks while sheltering."
We are to believe she knows where she got infected. Presumably she wore a mask, or she would be "Karen'ing" everyone else. So is this proof positive that masks don't work? Almost everyone who has gotten covid swears that they follow the rules and wear masks and yet, they got covid. Hmmmm! Maybe she should ask Dr. Biden.
Masks work - sort of. The virus spreads on air currents, and masks CAN, *SOMETIMES*, reduce those air currents. Sometimes, that's enough. The virus doesn't fly like a mosquito to a target; it's just drifting in the breeze.
But poly-ticks only deals in certainties, and FAKE certainties at that.
I also have experienced having a doctor visit in which he spends PERHAPS 2 minutes actually examining me; the rest of the time, he's poking at his computer.
It reminds me of the great computer "revolution" of the 1990's. It used to be that executives would dictate letters to secretaries, who would then type them up at 90 words per minute. Then all the secretaries were fired, and the executives were supposed to type their OWN letters - at 10 WPM. When they weren't playing solitaire, or looking at porn.
If your EMR does not allow you to write notes in whatever way you prefer, I suggest you switch EMRs.
Other than the fact that EMR can produce searchable data, they also make doctor 'writing' legible.
An example: A particular medication is recalled because it is not safe for children.
I can get a list of every person who was prescribed a particular medication in minutes. Try doing that through rooms of filed paper charts.
EMRs can make better physicians, but only if they take the time to study and analyse what they have done. Most do not bother and are stuck (like the author) in the past.
"Evidence-based" means facts, and an EMR makes find those facts trivial...
PS: I install an Open Source EMR called Oscar in Canada...
Yes, it's got really bad.
Gone are the good old days when pharmacies would hand you the wrong pills because they misread the scribbles of a doctor.
Gone are the good old days when if you got refered to another doctor the photocopy of the written scribbles in your medical file would take days to arrive by first class mail only to lead to confusion because nobody in the new doctor's office could interpret them.
Gone are the good old days of pages of other patients' medical records ending up in yours because they were misfiled.
Gone are the good old days of those mistakes leading to incorrect diagnostic and treatment decisions.
I'm so sad those days are gone and I can no longer get a leg amputated because a clerk filed the paperwork for someone else's procedure in my medical records, and I can no longer die from getting a high dose of some medication for a condition I don't have because someone misread a prescription.
and yes, my family experienced all of those things, sometimes regularly, before records were kept electronically and forwarded by email.
I was opposed to Electronic Medical Records at first on privacy grounds, but have come to like them. All my lab work, appointments, images, and procedures are available online from my home computer. I can click on a certain lab value and it shows the trend going back five years. I think knowing the trend is very valuable. As part of the "Patient Portal", I can send and receive messages or request a prescription refill from my physician(s) without spending the time and money for an appointment. Maybe I'm just lucky, but the doctors I've seen NEVER type into a laptop during an appointment; They actually ask questions and scribble notes onto a hard copy of my patient history; I assume they enter anything important into my medical record later. My eye doctor actually has a transcriptionist who sits at the computer in the exam room and enters all the numbers that the optometrist dictates during the exam. All in all, I think EMRs have made the practice of medicine better. (Insurance companies, not so much...)
"Electronic medicine" means the Docs can now push even more drugs, faster and more efficiently than before! Especially after a good TV night filled with medicinal recommendations from Madison Avenue!
That's what we need: MORE DRUGS! A lots of 'em! We even got drugs that take care of the side effects from taking other drugs! Get those sultry or "sharp" detail people out there!
Screw preventative health, integrated whole body and mind, fitness and diet related medicine!
Where's the profits in healthy people! THINK, people THINK!
""Electronic medicine" means the Docs can now push even more drugs, faster and more efficiently than before!"
That's just wrong.
The discussion is about Electronic Medical Records and the writing of doctor's notes...
As far as prescribing is concerned, the opposite is probably true.
With an EMR, physicians can be warned about risks of drug interactions as soon as they are discovered.
There may be a tendency to overprescribing meds, but that has nothing to do with the notes being written or stored elsctronically.
...and while we're bashing doctors, I want to report that my physician called me at home tonight at 6PM to let me know the results of a test I had today at the hospital. (It was all good)