THE FUTURE OF MEDICINE IS HERE

THE FUTURE OF MEDICINE  IS HERE
 
Have you recently gone to your doctor and  noticed some changes?  His waiting room is now called  a reception area. He is very concerned in cutting down the cycle time of you the patient, and you are limited to 7 minutes with him.   In the past he was reimbursed for his time and expertise,  but now non-traditional visits are handled by  phone consultations, smart phones, e-mail, or video chats.  The offices want your registration forms  completed by way of mail or computer so everything is available when you come in.  If you require 15 minutes or more, you will put you in  slots where he is not as busy.  His  practice is now being labeled  “patient centered medicine” rather than  "primary care medicine".

His usual jovial personality has changed, and you no longer can engage  in meaningful conversation about you, your health, nor even the state of Obama care.  He asks the questions, and you answer yes or no.

When  your doctor enters the room, he is now carrying a laptop computer.  Sometimes he will  put it on his lap, but  soon notices that the heat may fry his testicles,  and puts the computer on the counter.

 All the information you’re giving him seems overwhelming to him as he mutters under his breath and begins typing.  He  no longer is looking at you, but  remains focused  on the  computer data he needs to place in the registry.    Your visit ends and you wonder: "How on earth can he know what to do for me when I couldn't tell him what was wrong.
 
Charting has become more important than having a quality experience or quality outcome with you, the patient.  Your  doctor is forced to do this,  because of several new payment schemes, with names like “ accountable care organizations”, “global payments”,  and “ and bundled payments”---- all of  which are already in their pilots stages in  Massachusetts, Michigan and California.    The programs all aim for the same result: CAPITATION  ( another name for the old HMO).   To make all this work requires a great deal  of technological infrastructure.   So dear patient:  Your doctor, in order  to play the game,  must pay the price.

The electronic health records (EHR) certainly has benefits.   It signal potential drug reactions, makes prescriptions and notes more legible, and eliminates storing paper charts. The data however is very slow and cumbersome,  And reading it is very difficult,  as your doctor sifts through meaningless data trying to find your important information that will let him treat you properly. 

It is also very expensive. In a midsized practice, we are talking hundreds of thousands of dollars for the hardware and software just to get started.   This does not count the huge  annual service charges each month.  In the face of your doctor getting lower reimbursements for your care, and his rising costs of private practice, many  doctors are abandoning their practices and joining hospital groups.   Your next visit may  no longer be with your doctor, but his surrogate, or a nurse physician-practioner  aid.

 The new health reform bill,  called Obama’s Patient Protection and Affordable Care Act, is now the  law of the land.   The reform bill provides  incentives for doctors and hospitals to do less for you in terms of treatment and diagnosis, and to do more for the government by providing cost-saving data  to provide more quantity and less quality.  The meaningful use criteria for EHR is all spinned as leading to “ quality health improvement”.

 Certainly the  technology industry has a lot to gain. The dollars for your patient care are now being diverted into the pockets of Silicone Valley, the makers of computers and software.  Follow the money trail, and you’ll see who has the ear of Congress.

 These new  payment schemes, and the EHR  that supports it, penalizes your doctor when he interprets your medical findings properly and tries to customize a treatment plan that will work for you. 

 I think that you, the patient, still sees value in quality, individualized care, patient centered care, and compassionate care.  Hopefully you realize a one-size-fits-all approach to medicine will not work.  Regardless, get ready for more big changes in the way your doctor practices medicine.

Visit www.drneedles.com for more discussion of controversial medical issues that affect your health.
 
As a medical physician for over 51 years, I strive to give you the best medical information on controversial medical subjects, and help your read between the lines. You must come to your own conclusions. I have no ties to any organization, pharmaceutical, or lobby group. As an practicing medical acupuncturist since 1982, I find western medicine and medical acupuncture are very complimentary. This results in astounding healing in pain management, addictions to cigarettes and food, and a host of other maladies. Visit drneedles is blogging" at the end of each blog for a complete alphabetical list of all my blogs