“I’ll put my cell phone away when you put your computer away,” said the patient.
These were the very words I heard upon opening the door and stepping into the exam room. As I stood waiting for him to look up, I was already looking at my computer for his name. Needless to say, I was aghast that a patient would say this to me. My first instinct was to defend my actions. I need my computer. It has his medical records in it. It allows me to e-prescribe his meds. How can I not use it?
But was he right?
Then, the second thought crossed my mind: customer satisfaction. The administrators say I have to get excellent customer satisfaction reports. What to do?
I closed up my laptop and stared at my patient. In turn, he put his cell phone on the counter and climbed onto the exam table.
I resorted back to old-fashioned medicine. I actually did a complete SOAP note but not before explaining to him that we would talk, then I would examine him, then we would discuss his diagnosis, and then, I would need to go on my computer to confirm his medical history, allergies, and e-prescribe his medications. He agreed but added one more point: His medical records were stored on his cell phone so if he needed to clarify them, he would reach for his cell phone. We agreed!
So, I then said, “Let’s have a conversation!” and we did. Why was he there? What was worrying him? Questions I asked, he seemed to know the answers to. A couple of times he told me that if I wanted that information, he would need to pull it up on his phone. I told him to hold off on that.
Next, we covered the physical exam. He seemed patient enough.
Third, we talked about his diagnosis and his other complications and diagnoses.
Lastly, we both reached for our tech-savvy instruments. He went to his phone to show me his recent reports. I went to my computer to look up his allergies, past medical history he may not have mentioned and his medications.
Next, we started to clarify, correct, and clarify again. Was his cell phone accurate? Was my computer incomplete? We updated, deleted, and resolved issues, and then we came up with a plan which he and I both liked.
For me, this was a true partnership in medicine. I can only hope he felt the same way, and yes, gives me that nice customer satisfaction report.
Suzanne Fiscella is a physician assistant and founder, Patient Best.
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