About Amy Umble:
Amy Umble is health reporter for The Free Lance-Star

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In the treatment room, patients can’t compete with a computer

Dr. Steven Mussey said this week that the cartoon, below, he did for our May 22 newspaper was inspired by his patients. Patients have complained that when they visit doctors who use electronic records, the doctors pay more attention to the computers than to them.

Dr. Steven Mussey's May 22 cartoon.

“This is not coming from any single practice,” Mussey said.  “It’s coming from many different primary care and specialist docs in town who use EMR.” 

Mussey works with Dr. Lisa Sarber in a Fredericksburg internal medicine practice. He has a tablet PC, but the practice does not have an electronic medical records system.

However, that will soon change. “We don’t have a choice, because Medicare will be cutting pay for non-EMR practices. We will have to convert within the next 12 months,” he said.

Mussey said he fears that patients will be the losers when EMR is pervasive.

“By staring at the monitor instead of looking the patient in the eye, you lose the ability to decipher that the patient did not really come in for the described minor rash but is actually having an emotional crisis. The EMR becomes a barrier to care,” he said.

I, too, had a moment of recognition when I saw the cartoon. When I went to an urgent care center last year, the doctor spent most of our time together looking at and talking to his computer monitor. I sat on a table to his left, and he rarely looked at me.

Because of experiences like this, I have mixed feelings about electronic medical records. I like the idea that my medical history could be consolidated in one place and not scattered across half a dozen offices in this town. It would be more like a well-kept check register—portable, comprehensive and mine.

I picture this record being about the size of a credit card and carried in my wallet. I could take it with me everywhere and present it to any provider who treats me. The doctor could update it with the latest treatments and return it at the end of the visit. If I wanted, I could keep copies with preferred providers.

But, like Mussey, I fear that electronic medical records will mean less contact between physician and patient. When a computer and patient are in the same room, competing for a doctor’s attention, the computer almost always wins out. The computer has boxes to be checked and drop-down menus to be dropped down. The doctor doesn’t need to look at you when he asks, “Is the pain in both arms?” He does need to look at the computer to check, “Bilateral.”

Isn’t something lost in this world? Isn’t it important to look at me, to listen to what I say, and to lay on the hands?

Maybe the computer wins out because it’s a new addition to the treatment room. Maybe, with time, doctors will get used to it, and it will be no more demanding than a blood pressure cuff. Maybe so.