Friday, February 22, 2008

Patient Views - A Patient's Personal Medical Staff

On Wednesday, February 20, I ran across a poignant piece in USA Today, “Health Care Disconnect,” by Robert Lipsyte, who said , in part.

“I’ve decided to call a meeting of my personal medical staff, which includes a primary care doctor, an ophthalmologist, urologist, oncologist, gastroenterologist, neurosurgeon, dentist, dermatologist, audiologist, osteopath, and podiatrist, all of whom I have seen recently, but never in a group.”

“When I get them together, I will ask three key questions of this nation’s – as well as my own – health crisis. Will you get past your partisanship to talk to one another, will you feel my pain, and are your hands clean?”

“The health crisis we all share –getting good, timely medical service and being able to afford it – is too big for me and my staff to solve. But the overall national plans that the presidential plans propose will be useless unless they also help me get answers to my questions.”

“For all the policy wonk discussions about mandated care for all vs. affordable care, single-payer government systems such as Medicare and private policies, the heart of health care reform is about the doctor and the patient finding their way together towards compassionate care.”

“Even thinking about all this gives me stress. I might just have to add a psychiatrist to my personal medical staff.”

Mr Lipsyte, doctors are listening to what you and each other have to say.

Doctors are talking to one another, some through EMRs, some through FAXes, some through referral letters, some through phone lines, xome face-to-face, some through social networking websites.

Some are even asking patients what to do, what pleases them, what pains them. Milton Seifert, MD, a family physician from Excelsior, Minnesota, has formed a 60-member patient advisory council and meets with them regularly for guidance on everything from billing to what courtesies and services they desire and how he can prevent them from falling through the cracks.

Also in Minnesota, the state legislature will require all physicians to have interoperable electronic records in place by 2015 so all doctors will know what other doctors are doing. Minnesota, with financing from the state’s largest health systems and health insurers, has formed a non-profit organization, the Minnesota Health Information Exchange committed to building a network that will connect all electronic health records across the state.

Even in a state like Minnesota, where large medical groups and large health system dominate and where consensus is the societal modus operandi, whether such a system is doable and can be paid for while protecting patient privacy and without disrupting and bankrupting or disrupting small practices remains to be seen. Medicine, as Robert Lipsyte points out, is a very personal business, even though, unlike Lipsyte, most patients have not had the foresight to form their own personal medical staffs.

Getting people and physicians together in a country like America, where individual reigns and government intervention into private matters is resisted, to reveal all about their health condition poses daunting perhaps insurmountable problems. Frankly, I am not optimistic, nor do I regard it as desirable, or even possible to have mandated physician and patient health records. Some things are personal and will forever, and should, remain private.


Benjamin Wright said...

Dr. Reese:

Maybe "terms of use" could help patients protect the privacy of their health records.

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