by Joan Larsen
I am going to be honest in the telling of my story. In choosing my internist long ago, I wanted “the best” there was: a person very sharp, knowledgeable, and let’s not forget “caring”. Over the years, I developed a personal relationship with him as well. He beamed when he saw me. He was there and understanding when I was going through the health scares that turned out to be serious. What did it all come down to for me? To sum it up, it was obvious to me that he CARED. I thanked God for that on more than one occasion.
And then – perhaps a year ago – this doctor, who had always been a great part of my life, walked in with a perfunctory handshake, his eyes straight ahead, walking briskly to the computer at the desk. Hardly a word had been spoken and yet he was already typing as if filling out a form. Yes, the questions came, a quick glance at me now and again, but while his responses were well given, the wonderful personal touch was missing.
It was gone. Completely gone.
To say I was surprised, hurt, did not encompass the feelings I had. What had happened to our years of friendship as well?
As we, the patients, hit our fifties, we are in for a surprise. It seems that we begin to need specialists in the medical field as well. Again, I had gone to “the top” in my city. If I didn’t need these “wonders”now, one of these years these specialists might be saving my life. Again, on my visits I made sure that I was developing a personal relationship that was going to hold me in good stead later. They delighted in me. I felt I was going to be in good hands when I later really needed to be. Smaller “test situations” proved it to be so.
But the last visits were bizarre. The door opened and I was prepared for a warm visit, a time when they made me feel I was the only one on this earth. But not any more. Their eyes scanned me, glancing away, on the way to the computer. And then the typing started. I can’t complain on their being verbally thorough in their questions, but every word I said – and then some – must have been typed in as if I were there for an interview.
The personal touch was gone.
And then two emotional “doctor moments” occurred. The eye doctor headed for the desk as if distracted. As he held an iPad, I asked him how he liked that particular one. To be honest, it was a ploy meant to break the silence.
He turned on his stool, and tears rolled down his face. “I became a doctor to do good in the world and for my patients. Eye contact, looking over the patient in the beginning of the visit, is of utmost importance to a doctor. We are here to make you feel comfortable in telling your concerns and seeing that we care… and can help.”
He continued, wiping a tear away, “But we can no longer do that. We cannot face the patient as we are inputting forms to prove that claims for insurance are viable. Our ‘face-to-face’ with patients has become little to nothing as this typing out every detail takes all of our time. We have the next patient waiting but we always had built-in time for you. But with the time spent typing, I can no longer be the doctor that I once was and still want to be.”
I too could have cried. But now I understood that the medical world had taken a terrible turn. I was knowledgeable now, wanting to ask my own internist on my next visit. Both men were 50 years old – with years of experience. My internist leaned back. He too wiped tears over and over. In the next few minutes I felt like I was a therapist as he told of the present travails of being a doctor. The impossibilities of giving “his all to his patients” as he had always done were incomprehensible to him. His life was now about rules and regulations and filling out forms. He added that the added number of employees now needed to do all the financial insurance work had eaten further into the amount of money he was left with. “I have 3 children to put through college”, he said, “and I don’t know how I am going to make it”. In this case, he was a physician who had such heart that he took patients for free if they had no other hope. His office was full, his hours long. But his heart was fuller than full.
I believe we all have great reason to be concerned over this turn of events. We already see doctors thinking clerically instead of medically, acting like they are on a race course. The next step for physicians is burnout. I already have seen evidence of that in the tears that were shed – not once, but twice.
We have the modern electronic health records systems demanding more and more from the medical profession. The joy of the practice of medicine is all but gone, superseded by the pressures of complicated note-taking that is not just asked for. . . . but demanded.
I don’t know about you, but I am not just concerned. I am scared for myself and my family – and the world ahead for all of us.
I have researched and have yet to find anyone coming up with great solutions to a growing and most serious problem. As dedicated to being a great physician as so many young people would like to see themselves, I am guessing that many are thinking twice when they realize that one of their major areas of expertise is going to have to be sitting at the computer being a scribe.
Heaven help us!!!
Writer Joan Larsen has spent a lifetime searching for the most remote places on Earth. But it is the polar regions of our world that she has been drawn back to again and again. She has done research in these lands of ice, and considers Antarctica to be her “other home.”