Fifteen years ago, when I started using my current doctor as my primary care giver, the best part of any office visit was the chitchat, the catching up on family and work issues. Dr. M. is a petite, gentle-voiced woman in her forties or early fifties.
Her long hair and hippie-style fashion preference suits her demeanor perfectly. One would never mistake her for a technophile, although she is clearly bright and she knows her stuff.
Dr. M’s husband is her partner in the practice. Although I have only seen him once, I gather from things his wife has said that he is the business brain in the duo. And his brain told him around a year ago that he could no longer allow Dr. M’s preference for paper medical records to prevent him from computerizing them.
During my recent visit I suddenly realized how sweeping a change that computerization had made…on everything!
Dr. M. has always had the ability to make her notes during our visits without taking her eyes (and ears) off me, the patient. She made me feel that what I was saying was of utmost importance to her, the person, not just the doctor. But now, instead of my three-inch thick manila folder of records, she walks in with an iPad-like tablet in one hand, a stylus in the other. I could tell immediately that she wasn’t comfortable with that thing at all.
Before, when a question arose about what the lab work of 2012 showed, Dr. M would rifle through the stapled pages of that folder faster than a hummingbird flaps his wings. I used to smile at her and ask her when she was going to join the 21st century and computerize that file. She’d shrug, smirk and and shirk the question.
When such a question arose recently, she sat motionless for a few seconds, staring at the tablet in her hand. She began muttering to herself, struggling to remember how to get to the information she needed. As always, I continued talking, but unlike always, she wasn’t hearing a word I said. The rapport we had shared for one and a half decades was disrupted by her need to master the technology she never really wanted in the first place. For the first time I can remember, she actually turned her back to me to consult her computer, the desktop one that had information she couldn’t (or wouldn’t) find on the tablet.
This same feeling of separation of patient and doctor occurred the second time I met with the neurologist who diagnosed my MS, and has continued ever since. He had spent the first visit sitting at a keyboard typing as I responded to his questions about symptoms. Instead of a conversation, we were having a dictation session, I felt, and it didn’t make me feel cared for or about. At each subsequent visit, he would enter the room, greet me nicely, and proceed to his computer. I would have to sit in silence while he brought himself up to speed about who the hell I am, what my problem was/is, and how much testing he had thrown my way. There is no longer enough time left between patients for a doctor to review the file BEFORE entering the examination room.
The neurologist sees, on average, close to 40 patients per day! Office hours are from 8 a.m. to 5 p.m. and the guy has to get a lunch break. That means he must see at least five patients PER HOUR in order to meet his daily quota. And he spends 10 of my 12 allotted minutes typing?!?!
Technology is a wonderful thing. I am a fervent consumer of its newest applications. But the price we sometimes pay for the supposed conveniences of the internet and all the nifty devices being rushed to market by manufacturers is often in units of human relationships, and I find that disappointing.
