By Eve Harris
Not very long ago, a patient’s medical chart was considered proprietary information belonging to a doctor or a hospital. But just as technology is remaking the rest of the world, it’s also contributing to remaking the relationship between your doctor and you.
More patients have access to their data now that more doctors are moving to electronic medical records. Emerging technologies are also driving change. People with diabetes might use mobile apps to keep track of blood sugar levels, for example. So, with all this data at a patient’s fingertips, how is the doctor-patient relationship changing?
“Patients, when they come to the doctor seeking health care, aren’t necessarily looking for ‘raw data’ – they have already looked it up online. Instead, they are looking for meaning,” wrote Dr. Robert Rowley recently. Rowley is a family practice doctor in Hayward … but he’s also the medical director of Practice Fusion, an electronic medical record company.
Searching for meaning in the doctor’s office, I was intrigued. In an interview, Rowley told me that the role of the physician is shifting to “somewhat of a coach, a trusted advisor.” For example, a patient may want to discuss their medication if new or dangerous side effects were recently reported in the news. In a situation like that, Rowley told me, “My role is more of an interpreter.”
Rowley believes that the best care he can deliver today includes helping patients sort through and understand the “chaotic array of overwhelming data” as it relates to each person’s health. After doing a web search on their diagnosis, he said, “a patient will say, ‘help me understand this. Help me find meaning.’”
A study presented recently at the American College of Cardiology Scientific Session demonstrates the effect a personal doctor-patient exchange can have – not just on patients’ experience, but on their health outcomes. Cardiac patients in Los Angeles who had the opportunity to see their heart scans — clogged arteries and all — were more likely to follow risk reduction measures such as losing weight.
In short, the didactic, authoritative physician of the old days is giving way to that of highly trained medical coach or collaborator. In a recent New England Journal of Medicine editorial two doctors wrote, “The clinician needs to explain what is possible and negotiate potentially achievable goals with the patient. Then the clinician should provide a treatment plan, encouragement and advocacy to help the patient.”
Howard Luks is an orthopedic surgeon at and social media enthusiast currently serving on the board of the Mayo Clinic Center for Social Media. In blog posts and public addresses he, too, stresses that the doctor-patient relationship should be just that – a relationship. He tells doctors, “This is about stories. We treat patients. We don’t treat x-rays or MRI findings.”
But technology has a substantial influence on how the relationship changes, as with the cardiac patients who committed to losing weight not because the doctor prescribed it, but because the doctor showed them their clogged arteries.
Luks said recently in an interview:
Patients are…researching and diagnosing themselves through WebMD and then they’re searching for physicians who have expertise in that particular area.
Physicians are starting to realize that it helps us regain or recapture those relationships that older physicians had with their patients. They knew their patients…They knew their patients had a recent baby, or that they just bought a new house, that they moved, or they got a new job, or got a puppy, or whatever. Having a relationship with your patient in that respect for some is special and meaningful.
Much of that information is shared now via social media. Luks – considered when he speaks at medical conferences to be an evangelist about healthcare social media — tells physicians, “If you choose not to engage, then I feel that is to ignore your own relevance as a health care practitioner.”
Eve Harris is a Bay Area writer. Check out her health blog, A Healthy Piece of My Mind.