Since the implementation of computers sharing an examination room with doctors and patients has started, there is a debate as to whether the patient spends more time looking at the top of the physician’s head than the face and that it seemed that the doctor spent more time focused on the electronic record than the patient.

A blogpost by  Dr. Stephen C. Schimpff addresses his take of this problem.

“I’ve had the privilege and opportunity to work in a medical group which has deployed the world’s largest civilian electronic medical record and have been using it since the spring of 2006.  I don’t see the issue quite as much as Dr. Ofri did.  It is possible that she examined patients in her office with a desk rather than an examination room.If placed and mounted correctly in the exam room, the computer actually is an asset and can improve the doctor patient relationship. It is part of the office visit. The flat screen monitor can be rotated to begin a meaningful dialogue between the patient and I. We review the lab work together as well as the trends. Look at xrays. Who needs anatomy flip charts when I can google any image instantly? Patient friendly information to reinforce our discussion is a click away.

The computer can certainly enhance the doctor patient visit. Like any skill, unless we deliberately practice in getting better, we will simply find the new method awkward and unnatural.
And the same goes for emailing patients securely.

An October 2010 article in Pediatrics found that for a 127 families only 5 emails were generated compared to over 2300 phone calls over an 8 month period.  The data doesn’t lie.The conclusion of the article was that –
Although these patients/families expressed strong interest in e-mailing, secure Web messaging was less convenient than using the phone, too technically cumbersome, lacked a personal touch, and was used only by a handful of patients.So doctors could conclude that patients really don’t want to email their doctor.  What a relief because the majority of patients still do not have the option to do so and doctors don’t really want to do it.  (Though there could be compelling business reasons not to offer email to patients even if the doctors were technically savvy enough to offer it).But yet this earlier press release in July 2010 may cause doctors to pause before returning to paper charts, pens, and phones.  This study found that over a two month period, 35,000 patients generated 556,000 email threads.

So what does this all mean?  As doctors we need to change our mindset and look at these changes as opportunities for the medical field to provide care that is increasingly worry-free, hassle-free, and personalized.
The future is here.  That means embracing the computer.
None of my patients would ever go back.
Neither would I.”

What this illustrates more than anything else is that the patient wants to be informed and kept in the loop.  Unlike the older patriarchal models of medicine which is rapidly being discarded, patients want to participate in their own healthcare decisions and be aware of what is going on.

As doctors transition into usage of new technology, they will likely also settle into their new role as translators of medicine, bringing their knowledge and experience into the patient’s world.