Hitting a Nerve

Improving interprovider communication


“Interprovider communication” is a big buzzphrase in medicine these days. Granted, it’s an important aspect of patient care. But, like many words and phrases, a lot of substance is lost in the spin of things.

Dr. Allan M. Block, a neurologist is Scottsdale, Ariz.

Dr. Allan M. Block

I get emails, faxes, and letters all the time promising a new system that improves communication between physicians and patients. The hospital I share call at always seems to have something in its physician newsletters about a new software or app to improve communication.

The problem here isn’t that there aren’t already good ways for physicians to communicate – there are. I generally rely on the old standbys of a fax machine, with the post office as a backup for most things, and the phone for more urgent matters.

The real issue is people who don’t use the systems available, and no amount of technology will change that.

Some doctors feel they’re too busy to get a letter out, or forward tests results to another physician, or even have their office staff do it. Others just barely glance at anything that comes through, then pass it on to their staff to file it in a chart. At the hospital some doctors don’t seem to bother to read their consultants’ notes.

Granted, this isn’t entirely the doctors’ faults. As I’ve written before, many of the EMR chart systems are so full of templates and cut and paste that notes are rendered virtually meaningless. To find the impression – if it’s even in there – may need some digging. This takes time, which is always in short supply in a medical practice. The days when you could just flip through to the paragraph labeled “impression” are gone, and probably aren’t coming back. Which is good for no one on either side of the desk or bedrail.

This is sad, because that’s where the vast majority of physician communication happened. Letting people know what you’re thinking and doing, and at the same time asking specific questions you’re hoping they’ll address.

No amount of technological wizardry is going to make it easier to find meaning in a meaningless note, contact someone who isn’t listening, or hear from someone who isn’t talking.

Not all doctors are poor at communication – the vast majority are not. But for those of us trying to care for a patient with one who is, there isn’t a software breakthrough now – or ever – that will make it any easier, no matter how much time, money, and glossy marketing is thrown at it.

Dr. Block has a solo neurology practice in Scottsdale, Ariz.

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