I ran late the other morning. My first patient, an internal transfer, was already waiting. Booting up my laptop seemed to take forever.
Usually, I try to poke around at least a little in the EMR before I enter the exam room, even when I know the patient well in order to remind myself of what we are supposed to do in today’s visit.
I decided to walk in cold because I was so late. All I did before unplugging my laptop was open the encounter note of the man I had never seen before.
I knocked on the door and introduced myself – first and last name, I only call myself “doctor” with children or if I walk into a crisis-type situation where being a doctor allows or requires you to take charge.
I pulled up the little computer stand and sat down in the second chair right next to my new patient.
I did everything with him as in a guided tour of the electronic medical record, moving the cursor over things I oriented myself to.
“So, you’re 66, and it says here you’ve got high blood pressure, cholesterol, and a history of GERD. Let’s check your medication list … are you still taking Prilosec? It hasn’t been renewed since 2017 … or are you just buying it over the counter?”
I pulled up lists of blood pressure readings, commented on how the numbers seemed to have dropped at the same time he started losing weight last spring.
We looked at his immunization record together, and I cracked about both of us needing the “big boy flu shot” because of our age.
As we sat there, side by side, I renewed prescriptions and ordered his flu shot and a couple of blood tests, explaining exactly what I was doing.
He interrupted me: “You know, my old doctor never showed me the computer screen. It’s like it was secret somehow. I like the way you do this.”
I learned something in that visit. I show the screen all the time like this, but I have always tried to prepare myself for a new patient visit by looking through the chart before I walk into the room.
It was actually more powerful to start from scratch together, me exploring my new patient’s medical history and him seeing an EMR, his own story on the screen, for the first time.
Hans Duvefelt, also known as “A Country Doctor,” is a family physician who blogs at A Country Doctor Writes:.
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