Doctors office are not places people feel empowered. In fact, they are usually places of uncomfortable powerlessness. Some of this comes from the nature of sickness and human frailty, but far too much ones from a system that is cold and impersonal. This drives people away from healthcare, either avoiding care they need or seeking care from alternative sources, many of whom can cause great harm in the guise of care.
It doesn't have to be that way.
Good care empowers. It does so by putting the means to health in the hand of the one seeking health: the patient. It does this by:
- Improving communication. Communication is the essence of care: doctor listens to patient, discusses the situation, and communicates back a plan that the patient understands and agrees with. Our current system discourages such communication. My practice embraces it.
- Opening communication doors. People want to take care of themselves, but they don't know where to get information they can trust. The Internet, the evening news, and the friend with strong opinions are easily accessed sources of information, but is that good information? Who do you trust? People want access to someone with knowledge and judgment they trust, and someone who knows them and is willing to listen. This is at the heart of what I do.
- Putting records where they belong. Why can't anyone get a copy of their medical records? Why do man offices make patients pay for them, and why won't doctors work with patients to build a good patient-centered record? It's complicated. But I believe in a collaborative medical record - one that is owned and maintained by the patient, but one that I help organize, prioritize, and populate. In the normal doctor's office, the medical record is made for billing, not patient care. It is a tool to extract money from payors, not to keep people healthy. Direct care allows doctors to document in a way that is useful to patients and is focused on health, not sickness; on saving money, not getting more of it.