Leaning Toward a Better Doctor Patient Relationship
We have probably all thought about what we wish our doctor or our doctor’s office was like. I recently became a part of an amazing group of people at XPRIZE Think Tank Phoenix who are putting their heads together to think of solutions that would make healthcare more like what patients and doctors want it to be. At a recent meeting they came up with a list of wishes that they would want from their doctor’s office. The writing in black is the list they produced with minimal alteration. In blue is how we at Ark Family Health hope to address these concerns. We know we don’t have all the answers, but we are excited about the answers we do have.
Below is a list provided by the roundtable discussants of their idea of what a doctor should do.
I wish my doctor:
A. Would provide all test results as soon as practical with background and interpretation
Doctors in a regular office have a hard time getting back to patients because they don’t get paid to call people back and despite how it may look, they don’t get paid well enough to call everyone and still feed their families and pay their student loans. At Ark Family Health, you should expect to hear your results from your doctor (not an MA) on the same day the lab results them.
B. Could have an open, honest relationship with me
Time constraints, fear of getting sued and a paternalistic philosophy embedded in our training make open and honest relationships difficult for most doctors. Let’s kick the 7 minute doctor visit to the curb (unless that is all the patient wants). We will have the time to form the relationships both doctors and patients want to have.
C. Did not have to deal with insurance
Yes please! Insurance will always be an important part of sick care but let’s do away with the middle man when it comes to primary care, preventative care and lifestyle medicine. An affordable membership model makes that possible.
D. Only recommended necessary visits, drugs, etc.
If the doctor doesn’t have to bring the patient in in order to get paid, unnecessary visits go out the window. Unnecessary drugs are largely a function of weak patient/doctor relationships. Doctors follow protocols and guidelines to avoid getting sued and because they don’t have the time to understand what is really important to the patient.
E. Would facilitate multiple diagnoses in one visit
Covering multiple diagnoses in one 7 minute visit is dangerous because there is no way to do justice to all of them. Covering multiple diagnoses in a 45 minute visit can be awesome for patient and doctor.
F. Educated for prevention
80% of chronic diseases can be avoided with lifestyle medicine (i.e. using food, exercise, rest etc as treatment). Doctors aren’t practicing lifestyle medicine because they are too busy putting out fires with too little time to do it. Educating for and supporting healthy lifestyles takes time. We can make that time.
G. Was free to practice healthcare rather than being confined by legal and financial boundaries imposed on them by FDA, legal cases and insurance carriers.
Breaking free from insurance companies does set you free from many financial boundaries but their are still a lot of questions about how to get important things paid for. We will deal with legal cases and the FDA later.
H. Helped me see my Whole Situation
Yes! So much of this comes back to having the time in the appointment but also time for the doctor to prepare outside of the appointment. We give lawyers a week to go home and research our legal problems but we expect doctors to give us a definitive answer on the spot without any time to read up on the latest research or to study our history.
I. Would facilitate all medical records to be available at all visits to all doctors (x-rays, CT scans, MRI’s, etc. at full resolution)
That’s doable now. In the future it should be a lot easier.
J. Provided a dashboard of my data
Most EMRs are incorporating this now. It should be universal within a few years.
K. Called me with lab results within 24 hours
Agreed. Addressed above.
L. Called to follow up @ 3 months with my health statistics a) review tests that have been performed, b) general care to include nutrition and holistic care
I love this suggestion. It’s doable now but better technology will help.
M. Had data on my environment, e.g., radon levels in my home, as well as my lab results.
I have no smart answer for this but we will look into it.
N. Worked in a team of docs with several skills who will evaluate me and offer treatment w/o regard to legal or insurance constraints but considering my financial constraints.
Teamwork is almost non-existent in medicine. Why? Again because the financial numbers don’t allow for it. I should have made this point earlier but doctors aren’t just being greedy (at least not all of us). Say we wanted to give better care including calling specialists of all our patients. To do this we would just have to cut down our patient load by 30%. That should be fine you say, you rich doctors could stand a 30% pay cut in order to actually do your job right. But seeing 30% fewer patients doesn’t mean a 30% pay cut when overhead is 70% of your gross income. By cutting down by just 15% which is hardly enough to make a difference in your care, you might lose half of your net income which makes it pretty tough to pay off a half million dollars in student loans.
Again, I am not the authority on all of this but this is how it looks to me. I think we can do a lot better.