Switched Keys

I visited a new family practice physician earlier in the week and found the trip to be well interesting. This is not going to be a recommendation in either direction but some thoughts you might consider. I can't make recommendations because I didn't require any treatment. The physician just did the routine doctor checkup. The practice Short Family Medical Group is in a very new office. During its construction I drove by there on the way to church every Sunday and only noticed people had started moving in the last couple months.

Electronic Records One of my first observations was the use of an electronic medical record system. I saw that when I first made the appointment and then during the visit. That's cool I thought although when I reviewed a printout of my basic information I noticed that the spacing of the information didn't allow much room for making corrections. With forms analysis being one of my specialties I had mixed emotions about all that. I know it takes time to develop but it can be done should be done before software is deployed. At my previous doctor's office I had similar thoughts about the way the hand-written forms were formatted so it's apparently a common problem. The computer system was networked and there was a computer available during the exam. During my time in that little room as Seinfeld once described it the doctor and nurse appeared very comfortable with the system although at one time one of them had to repeatedly click an OK button before it would close. I could see "Not Responding" in the window title bar but it did eventually close. The problem there could be either software networking or hardware. In any case EMR is still somewhat new so it's hard to know (especially for someone that's not computer savvy) where to go for a good package. But they are on the right track and in the top 10-20% that have adopted EMR.

Web site. Throughout the visit I checked the cards forms and such and found no mention of a web site. It's a new business so that could be in the plans. With the ridiculously low cost of creating a site I think every business should have one. I'm not talking about just an on-line advertisement. A web site in my opinion should be a source of information. Not just about the facility but information that might augment whatever service they office at the store front.

How fast is too fast? For a new business this seemed to be a busy practice but apparently efficient. The staff covered all the bases for insurance release of records and such. The doctor was also pretty quick and somewhat efficient. She was doing things while she was asking questions. But then all practices seem to operate that way. If you have a problem you have to be quick to let them know what's on your mind. Apparently they are trained to ask specific pointed questions and not allow the patient to start a conversation. One of my previous physicians is now retired and volunteers at a non-profit clinic. He's shared that one of the things he enjoys is he gets to spend more time with the patient. So maybe the quickness of an examination is how it's done now. I was impressed that this new doctor did come back to see me before I left though she could have left me with a nurse. It will be interesting to see how this practice develops.

Tests The reason I was seeing the doctor was to get prescriptions refilled and that was handled without a problem and to get routine blood tests. A former physician used to discuss with me what tests I need to get and my treatment options. I missed that. I had a handwritten list of tests I wanted to get done and some notes on other things but didn't get a chance to present it. They did take blood for tests but I won't know what tests until I get the results. My list was pretty standard so they may all be on there. CBC CMP (metabolic) Lipids Thyroid and PSA. I was somewhat surprised that this doctor also wanted to get an EKG. There is a history of heart disease in my family but other than mild asthma I'm in excellent health.

Details That brings up another pet peeve I have. With some exceptions doctors don't tell you how you did on a test other than to say you are okay. I don't want to hear that my PSA is okay or my HDL is borderline. I want to know the numbers. I like details. I suppose that all goes back to the idea of education and why it's one of the concerns of JCAHO. Other than the 2-3 hours a year that I'm in a doctor's office I want/need to be in control of my health. In fact if I hadn't taken control of my health 20 years ago I may not be here but that's another entry. I did get the results today and it does have all the gory details. Yes the results look fine according to the doctor so I am still healthy. But by looking at the numbers I see that I am back at the Cholesterol border. With Thanksgiving meals and now Christmas parties I'm not surprised. With LDL a little high low HDL and high Triglycerides I have some work to do. It's always easy to head them off before they get across the border. I'm not alone with that obsession. "People today aren?ÇÖt satisfied with just being told 'everything is fine'.... They want to know the exact number and what it means." So says Jim Nichols PhD. who directs the Clinical Chemistry Laboratory and Point-of-Care Testing at Baystate Medical Center in Springfield MA.

Doctor's Orders I didn't really get any orders from this doctor. We will see the next visit. She did say she wanted to set up some breathing tests something that was already on my list. Now you may like being ordered around but I'm not that way at least not at work home or at the doctor's office. I'm the kind of person that wants to know why and to have options. There are options in treatment and rather than depending on the physician to weigh the options I would like to know what they are. The main reason I'm seeing a new doctor was my previous doctor decided to change the treatment for my asthma even though it has been effective for several years and there were no contraindications. With the options that he gave me I also got an ultimatum. Again that's another entry.

Choosing a doctor So why this doctor? Knowing which doctor to go to can be challenging. When I started looking for a new physician I first checked the insurance provider list. In the list I narrowed it down to physicians that were boarded. From that list I mentally eliminated physicians that were part of one of the hospitals. Then from that very short list I selected a new practice.

Independent I eliminated physicians that were not associated with a hospital because I wanted to support someone dedicated to the health care of individual patients. The all under one roof super-market approach to health care doesn't appeal to me. It has a nice ring but it's misleading. The physicians there work for the hospital. An independent physician has a lot more freedom to decide what works for me and a successful independent won't be forced to leave the system by some administrative order. Our society is driven too much by big business and big government and that couldn't be more true than in the health care industry.