I saw it every day while in medical school and residency; attending physicians cowered behind a computer screen, attempting to feverishly click or type in the patient encounter note while simultaneously ask the history and review of systems. This was not because they lacked empathy or proper training on doctor patient communication, but simply because of a lack of efficient use of technology in the exam room. For those who are not great typists or less tech-savvy, dictation software has helped them to remain efficient and continue to focus on the patient during the visit by making eye contact and giving appropriate confirmations and reflections during the history and physical examination (H&P).
Embrace New Technology, Share With Your Patient
Now, the above scenario can easily be remedied. When talking with a patient to discuss the assessment and plan (A&P), you can incorporate new technologies to more fully include your patient. If you turn your monitor and bring up an algorithm calculator on your computer screen or tablet for diagnosis and management as opposed to staying hidden behind a screen this brings a unique opportunity to engage the patient with tech.
Explain Your Diagnosis with a Medical Algorithm
A 19-year old female college student with several week history of malar rash, photosensitivity, and an oral ulcer returns for follow-up and review of labs obtained a few days previously. The patient is obviously anxious to review the findings and has been searching the web excessively since she last was seen in the office. While the discussions with her in the prior appointment broached the subject of autoimmune disorders, now there is the opportunity to show and educate the patient where your diagnosis of systemic lupus erythematosus is coming from.
Practice Patient Inclusion for Better Relationships
I have found that when discussing broad differential diagnoses or bringing up the possibility of a chronic disease or autoimmune illness, showing the patient or parent an algorithm calculator result while educating them on my recommended next step in diagnosis or treatment, helps them feel more empowered. Like many of my colleagues, I have found that the likelihood of the patient or family following my plan is higher when they are involved with the use of an algorithm calculator and other technologies in the exam room. They also ask better questions and are more willing to read recommended resources providing them with more useful information on the diagnosis. Patients in 2015 want to be a part of their own healthcare. The days of patients just doing what the white coat-wearing doctor tells them are fading, if not already gone. The road to better patient-physician relationships and improved quality time in the exam room can be found through “old-fashioned” communication skills combined with new technologies.
