Delivering Health Care is Like Practicing a Religion

A former brother-in-law was a chiropractor. We never talked shop. But the longer I am in this business, the more I believe in our bodies ability to heal. If hypnosis can cure warts, we can’t be too rigid about how our patients tap into their own ability to feel better.

Scientific American writes:

For centuries, the idea of “healing thoughts” has held sway over the faithful. In recent decades it’s fascinated the followers of all manner of self-help movements, including those whose main purpose seems to be separating the sick from their money. Now, though, a growing body of scientific research suggests that our mind can play an important role in healing our body — or in staying healthy in the first place.

I wrote about this in 2008 and I am even more relaxed now about patient seeking alternative methods to tap into their inherent abilities to heal:

You wouldn’t ask your rabbi how often you should go to confession, would you? Chiropractic and allopathic medicine are like two religions. We don’t speak the same language and we use different tools. But even though our practices are different, we ultimately work for the same higher purpose, and it may be that our differences are smaller than we were taught. We don’t know enough about each other’s practices to make specific recommendations, but support you, our patients, in your pursuit of better health and wellbeing.

So, still, while I support my patients pursuit of alternative ways of healing and gladly sign insurance authorizations for that, I have to admit that I feel uncomfortable choosing such practitioners. I just don’t know who is good and who is a good fit because we come from such different cultures, or different religions, for lack of a better word.

Make it So

A year ago today, from a different galaxy (EMR) I wrote a piece that is equally relevant in my new galaxy (Epic). In fact, even more so. Epic is even more click and encounter heavy than I could imagine.

I wish I could be like Captain Jean-Luc Picard and just say “make it so”. Instead, be it Epic, Intergy or eClinicalworks, I have to do a lot of things that are not medical in order to basically say yes to a request from a colleague or support staffer.

This is what I wrote:

In my EMR, when I get a message (also called “TASK” – ugh) from the surgical department that reads “patient is due for 5-year repeat colonoscopy and needs [insurance] referral”, things are a lot more complicated, WHICH THEY SHOULDN’T HAVE TO BE! For this routine task, I can’t just click a “yes” or “authorize” button (which I am absolutely sure is a trackable event in the innards of “logs” all EMRs have).

Instead, (as I often lament), I have to go through a slow and cumbersome process of creating a non-billable encounter, finding the diagnostic code for colon cancer screening, clicking on REFERRAL, then SURGEON – COLONOSCOPY, then freetexting “5 year colonoscopy recall”, then choosing where to send this “TASK”, namely the referral coordinator and , finally, getting back to the original request in order to respond “DONE”.

This is a basic, binary, programming issue as far as I understand. Yes or no, 1 or 0, stop or go, scope or nope.

I really think EMR programmers have something against doctors.

Osler said “Listen to your patient, he is telling you the diagnosis”. Duvefelt says “Listen to your patient, he is telling you what kind of doctor he needs you to be”.



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