Thursday, March 17, 2011

Family Medicine: Working and Caring are in Transition

Family Doctors have to "get the work done" while caring for people.  Sometimes the two responsibilities conflict.  How do you know if your doctor is working on your behalf so much that you don't feel like they care about you?  When they seem to be caring about you in a unique way, how do you know they're not being distracted from the work of gathering, analyzing and recording information about you relative to your chief complaint. 

Could they care too much and overlook important clinical information while you are feeling very pampered or special?  Or fail to record the pertinent information that enables their cross-covering physician to be able to treat you when your physician is on vacation?  Could they be overly concerned about the patient satisfaction survey you will fill out later (about their bedside manor) enough to miss an important clinical finding?  Could they be so concerned about you that they go out of their way to get your special tests at the most cost-effective site with good quality, saving you a lot of money?  Could they "forget" that the physical therapy office in the building next door is open 7A to 7P, allowing you to get your PT without missing work?  Could they remember to tell you that the hospital owned PT down the road is only open 8A to 5P and costs $500 dollars more for a course of physical therapy?

If the doctor is a bit mechanistic but very thorough clinically, can you overlook their logical, rational excesses?  If the medical assistant, nurse and receptionist are extremely friendly and calming, does that make up for the doctor's seriousness?  Can the overall work and care of the team suffice to meet your needs in those important areas?

Care and work used to fit well together.  Now they might get distracted at times as we transition to electronic medical records (EMR) and you ponder the addition of a personalized health record (PHR) for your personal use.  We care a lot while we work for you.  Most doctors also are employed by a bigger company that they are responsible to, so some aspects of the work include considerations of corporate rules and policies, adding to some of the distraction. 

All physicians want to help patients.  They also like to eat.  The balance between working and caring includes considerations for BOTH patient and doctor.  BOTH have to work and care.  Both have to eat.  That's how, together, we make it into the era of EMR's and PHR's, as humans committed to each other's success through caring and working.  It's not EITHER/ OR but BOTH/ AND.  Both patient and doctor have working and caring to do.

Caring and working.  Working and caring.  Every day, every patient.  Every patient, every doctor.  Work and care.  Both important.  What do you think?

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