The credit for the title goes to the Who. “See Me, Feel Me” is the name of a song from the 1969 album Tommy. Were the Who visionaries? Did they look into the future to see health care in the 21st century?
This post is based on a personal experience. Not too long ago a father takes his daughter to the pediatrician for what was going to be the last visit before transitioning into adulthood. The appointment was for a physical examination required for the college admission process. The group of pediatricians had provided great care for almost a decade.
The visit started as per past routines with a very courteous greeting. However, it was soon obvious that there were now external forces at play and that this visit would be different. The focus of the visit quickly turned to the lap top computer that was 8 feet away in the corner. It started with a review of the medical history. Time was 2 minutes. Eye contact time = 0. Distance from patient = 8 feet. Then a long list of symptoms each acknowledged with the click of a mouse. Time was 2 minutes. Eye contact time = 0. Distance from patient = 8 feet. On to the physical exam. Wasn’t sure what was going to happen here. With telemedicine on the horizon there may be a day when the physician can stay in the chair or even not be in the room. But yes the computer was abandoned for the exam. Time was 5 minutes. Eye contact 1 minute. Distance from patient appropriate. Now back to the computer for a wrap up. Time was 2 minutes. Eye contact = 0. Distance from patient = 8 feet. Eleven minutes in the office. For over half the visit the focus was on the computer which was 8 feet away from the patient.
Is there a real benefit to this method? Isn’t the amount of documentation the same irrespective of when it is done? In other words was time saved by doing the documentation during the visit as opposed to at the end of the day? And if it can be shown that you can see a few extra patients in the day is it worth it?
The actions always speak louder than the words. The focus of this visit was on rapidity and documentation. One could argue that this “wellness” visit may be completely different from that for a patient with a medical problem. Would be interesting to see if patients with real medical problems have the same experience. In that humans are creatures of habits the sick visit most likely isn’t much different from the wellness visit.
This experience is a great example of how the focus of health care has moved away from the patient. They gave in to the corporate model of medicine. Just running faster on the little hamster wheel. Most of the time it is just easier to acquiesce. But will the patients tolerate this model or will they demand better? They should.