6 top medical comments, May 31st, 2009

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Here are some of the more interesting comments readers have left recently.

1. Dr. Grumpy on the art of medicine and electronic medical records:
I do use an EMR, but patient’s routinely tell me I’m good at listening. I think it’s an individual basis. Some doctors are technophiles, and put that first. That ain’t right. Some doctors are so intent on listening, that they may forget a detail, and then it doesn’t get entered later. That can also lead to problems. The key is a happy medium. Sometimes you just instinctively know when you shouldn’t be typing away.

2. Lizzie on whether doctors should discuss medical costs with patients:
Doctors are in a position of trust. They’re the ones with the knowledge. I don’t want to second-guess their recommendations – but really, they need to understand that their decisions about prescriptions and follow-up care have a real impact on many of their patients’ finances. I believe they have some responsibility to their patients in this regard. How and to what extent, I cannot say. I don’t know how you broach the subject or even identify a patient who may be at risk financially. Perhaps having a basic understanding of the cost of medications is a place to begin.

3. Matt S. on how Google has led to the demise of the medical riddle:
Google HAS killed not only the riddle, but more practically, the challenge of the difficult diagnosis. I’m currently a medical student and although I adore a tricky patient more than anything else in medicine, I’ve ruled out internal because of this looming change. I feel that much of the job satisfaction of being an internist will be history as soon as computer software can out-diagnose and out-manage doctors. And it WILL happen.

4. Chris Seper on the power and influence of Oprah Winfrey:
The worst Oprah episode I saw was with Jenny McCarthy in which Oprah, almost grudgingly, read a brief statement from a medical association countering McCarthy’s claims – and then let McCarthy tee off. I think the medical community should pressure her physician friends (the Roizens and the Ozes of the world) to speak truth to power. And the medical industry, which has just as many star-studded friends, should use those connections for their own media blitz.

5. Carla Kakutani on how primary care doctors should embrace retail clinics:
The problem is balancing convenience with continuity. In an integrated system with communicating EHR’s, the whole concept is quite reasonable. But in our current state it represents yet another layer of confusion, along with other stand alone concepts designed to “fix” little parts of our broken system.

My husband the auto mechanic is forever frustrated by people who take their car to a different place every time, until no one knows what’s been replaced or fixed. The trials and tribulations of a family doctor and a mechanic are very similar.

6. Chris on whether smartphones will ever replace the doctor’s pager:
I was a strong supporter of ditching our pagers at work until Hurricane Ike last year. With the massive influx of evacuees, the cell phone networks could not take it and were rendered nearly useless. SMS was delayed >30 minutes and phone calls would take 20+ attempts to get through. I am still working towards getting our administration to use SMS to supplement pagers, but not replace them. 360 days of 2008 phones worked great here, but for those other 5 days, pagers became a very important tool.

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