Word: patient
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...doctor will tell you the advantages of having lots of patient data on computers: it helps us avoid redundant tests, gather huge amounts of data for research, screen automatically for drug interactions, all with no problems with our famously illegible handwriting. I would be happy if every patient could hand me a digital file of everything about him; it could really save time on first visits. But against our government's push to get all patients' records computerized we must keep in mind there will be a cost to this - far beyond the billions to be spent setting...
...never quite sure that what we've typed is going to be seen by a real, live, analog nurse, that it isn't just going to disappear. (It does.) We can't order certain things with those buttons and pull-down menus that we could in writing - things like "patient may wear her own flannel nightgown and underwear" or "please, please get the x-ray I ordered for yesterday", or "prop up patient's legs with pillows like this" followed by a little stick-figure drawing. (See pictures from an X-Ray studio...
...that medical data on a nationwide computer network is privacy. Who gets to look? How do you limit access to information and respect privacy when managing a disease, like diabetes or AIDS, that affects many organ systems and so involves many different kinds of doctors and services. Doctor-patient confidentiality seems quite likely to be one of the sacrifices Americans will be required to make to get this project going...
...consider that nearly every patient who has a big hip or knee operation will run a fever for a while afterward. No one really knows why. But let the computer pick up the temperature elevation and make me address a pull down menu that includes "fever of unknown origin" and I have to add a diagnosis to the patient's chart that often means a bigger payment - though the only treatments for this fever are being given anyway...
...greater capacity to do things like go to school regularly. The authors conclude that drugs, while they can help in the short term, don't stimulate long-term behavior change. By contrast, with ACT, "the target in treatment is to clarify and reduce avoidance behaviors that prevent the patient from living a vital life," the study says. (Read "On the Couch Online: Does Tele-Therapy Work...