We must work to keep the ability to have personal human interactions with patients
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There are many unique challenges in the current physician work environment. A broad view suggests physicians are living in a time when the collective human spirit is at an unprecedented all-time low for modern times.
This comes as we are on the brink of technological innovations that will change how physicians interact with each other and the world. However, this may not be positive. Physicians need to refocus on the importance of human social interactions as a crucial source for a satisfying life. Our world is much different than it was 100 years ago. Our world has become increasingly disconnected and impersonal. We are more involved in activities that limit direct human interactions and connections. This can be a significant cause of mental illness and burnout in medicine as we highly value human interaction.
Digital technologies
Relationships appear to be more transactional than interpersonal. We lean toward digital communication instead of direct conversation. Automated services that complete daily tasks, such as banking or shopping, continue to increase. Social media and marketing programs are aware of our preferences and constantly bombard us with similar products, services and ideas, creating an echo chamber where minds are not exposed to new ideas or people.
As businesses compete to become more successful, which is usually equated to increased revenue through innovations and applying efficiencies in the management of spending, there is a movement toward a unified or single approach that is expected to fit everyone. Some technology offers the promise of individualization, yet channels users to similar algorithms that feel remarkably similar and impersonal.
Physicians see these issues in health care as a sector of the impersonal world that has developed. Increasingly, our ability to practice medicine in a way that allows us to create a trusting relationship is assaulted by nonphysicians who analyze data and provide their interpretations of best practices, which is often a term related to best revenue.
Personalized care
By restricting resources to support the physician yet creating an increased flow of patients to a practice, a bypass has been created to avoid the accusations of violating the prohibition of the corporate practice of medicine as it becomes impossible to provide personalized care without the time needed to develop relationships.
We have become cogs in the wheel of generating revenue in a low-margin or zero-margin environment, with the hope from employers or partners that downstream revenue through ancillaries will maintain a reasonable margin to support our compensation. The dominance of electronic medical records in our lives wastes countless hours on administrative and clerical responsibilities, taking time away from patient-physician relationships and patient care.
While the EMR programs have benefits, the primary focus feels as if it was designed to capture every billable activity possible to maximize revenue. It is unlikely all required documentation has anything to do with quality and improved patient care. The responsibilities of a physician often interfere with patient care and the patient experience. Computer entries during an office visit to avoid hours of work after an office day may lead the physician to work like a scribe, focusing on their entries into the computer rather than direct patient communication.
Look ahead
As we end 2023, there is much concern about what lies ahead for practicing orthopedic surgeons. Without question, more orthopedic surgeons will be employed, the value of our downstream revenue will be artificially diminished so the revenue can be distributed to other priorities of the health care system. Many characteristics of our practice will be influenced and, in some cases, dictated by nonphysicians. While technology offers advancements and possible assistance with data-driven personalization of care, the most noticeable impact that technology currently brings often worsens the impersonal nature of our interactions with patients and their caregivers.
Without valuable, in-depth, personal relationships with patients and staff, the mental health and burnout issues currently seen among physicians are unlikely to dissipate. These relationships fuel the human spirit. We must work to maintain the ability to have personal human interactions and experiences with patients, using technology to augment, but not replace, the process.
We need to have interactions at a level that nurtures our souls and the souls of our patients. We need to see our patients for who they are, not the questions they answered on a survey. We cannot underestimate the power of human interaction and human intuition as the foundation of the highest quality of care.
Patients recognize that high-quality health care as it is meant to be happens most often when physicians and patients develop trusting relationships. Physicians see the whole person in front of them, respect them for who they are and give their best, which is supported by technology, to provide the best possible comprehensive health care.
- References:
- Adel W, et al. Ann Surg. 2022(5);doi:10.1097/SLA.0000000000004575.
- https://www.ama-assn.org/practice-management/physician-health/measuring-and-addressing-physician-burnout
- For more information:
- Anthony A. Romeo, MD, is the Chief Medical Editor of Healio | Orthopedics Today. He can be reached at Healio, 6900 Grove Road, Thorofare, NJ 08086; email: orthopedics@healio.com.
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