OT: Changes At The Doctor's Office

[Slinky]

*sigh* The entire staff at my family doctor's office has changed after all these years. All new staff. We haven't had a chance to get to know the new gals. I mean, how often do you have to go the doctor before you get to know the staff?

He's switching to the electronic medical records. Which is okay because he has a staff person specifically to collect and do all the 'puter work so he still looks at you instead of a 'puter screen and he still talks to and with you instead of a 'puter screen.

BUT, his waiting room has always been pretty, I love the color scheme, but tile floor, no curtains, decorative blinds. Not exactly warm and inviting. The reception desk was wide and rounded and you could see the staff and hear them chattering tho you couldn't hear that they were saying, still you could hear their laughing and banter and if you caught their eye they smiled and/or waved. Or they said hi and smiled.

Now, they have walled all that off w/glass blocks w/just a small window type opening. The sign in clip board sits on that window sill. You can't see thru the glass blocks. Its all so cold and stand-offish and unfriendly feeling. We are divorced from the office and staff totally until called to go back to the exam room.

His nurse practioner calls us back, weighs us, does the BP, temp, pulse bit, asks why you're there, if you need script renewals, etc. and fills all the data into the 'puter. Then exits w/the 'puter.

Then our doctor walks in and is his usual pleasant self and all goes as has before. When done the new receptionist schedules our next appointment or calls the facility to make an appointment for any procedures suggested, give us any scripts ordered, etc., etc.

I HATE IT!

[jweeks]

Hi,

I have decided that I will not visit a clinic or doctor that isn't part of the electronic health care record system that I use. I absolutely love being able to submit questions, schedule appointments, and do follow-ups on-line. I also like seeing my test results on-line as soon as they are ready. In addition, it is so convenient to be able to have different staff see the test results so I don't have to repeat the tests when I visit a specialist, and it is nice to not have to repeat my medical history each time I visit someone new. The medical stuff takes so much time, and the electronic stuff really streamlines the process.

I haven't run into an office yet that uses a window. Each clinic that I have visited over the past few years has a front desk. I would prefer a little more privacy when I come to a clinic. While I am pretty open about my issues, I really don't need everyone in the waiting room to know my name, hear my phone number, or know what I am being treated for. In fact, I don't like them to call my name because no one else in the waiting room needs to know who I am.

-john-

[Starlette]

Slinky,

I have both extremes:
The warm office is where my PAC is located.
The cold office is where my Neurologist is located.
I know the feeling of both very well.

Starlette

[Wonderbeastlett]

My husband recently had to go to a specialist and they used laptops. They would walk around with them and while the doctor was questioning my hubby, he would type stuff in and click stuff with his special pen. It was such a small office, I didn't see the need for that type of technology. I also didn't like that when we had to schedule an app, he would occasionally run through other peoples apps or results on the way. I didn't know anyone listed but it made me uncomfortable that I was seeing their stuff and that they could possibly see my hubs. I mean, I am originally from Michigan and in the very small towns up north everyone goes to practically the same doctors. So, I don't want Miss Gossip/Nosy seeing my test results because the doctor can flip through pages while making appointments. Perhaps he was just careless but my doctor approval rate is slipping.

[Slinky]

Well, I didn't feel good today. In fact I felt lousy! I asked whose brilliant idea the glass block wall was and he said the new office manager's. That they got some good reviews, some not so happy reviews. I told him he ought to ditch her and get a patient friendly office manager. This cold fish was gonna cost him. If I didn't like him so much I would start doctor shopping.

So I'm on prednisone and some unbelievably expensive and powerful antibiotic and have to go back in a week. I don't even want to go back.

[Paulrp]

I have to agree with jweeks here, I wish all my info was available to all my doctors. We need a national medical records system, no implanted chip crap, maybe a thumb drive or smart card.

[chunkyfrog]

I just wish they would get rid of the {{{blessed}}} voice mail.
I press 0 and it hangs up.
--It's a DOCTOR's office, for pity sake!

[Slinky]

Oh, yeah. I forgot about that. As long as I'm griping. We now have an automated appointment reminder phone call. What a freaking PITA! It is a l-o-n-g message, after which we are given the option of pressing one number to acknowledge receiving it and agreeing we will be there on time, another if we can't make it and want to reschedule, another for ... whatever. I don't even bother to pick up the phone and just delete the message when done. I'd rather they not call at all for that purpose.

[Julie]

At the risk of being unpopular, I worked in similar conditions for years and when we moved to a new bldg one year, worked with the doctors on the new set-up. One thing I appreciated was having a little more privacy to work in, rather than feeling constantly in a fish bowl. Yes, we liked the patients, but also needed a break at times even when we weren't stuck on the phones, from patients talking loudly on their own phones, little kids running riot, people wandering over to talk when we were crazy busy, or asking us to look up something or other that absolutely didn't need doing right then, etc. etc... don't forget, we were working, not just waiting to see the doctor... and also had the doctors giving us instructions from 'behind', along with the phones going, patients checking in and out, etc. etc... works both ways unfortunately and while being social would have been more fun, we had to get things taken care of.

[SleepDepraved2]

While I like some aspects of the EMR, the other aspects of it scare me to death.

As a transcriptionist, I wouldn't want my doctor responsible for inputting the information into my record. A lot of them don't know how to spell or even pronounce some of the medication names. And as overbooked as almost all of them are, they just wouldn't have TIME. I have transcribed for some very wordy doctors who would definitely not have the time to type their own reports, at least not the detailed ones they usually dictate. So they will end up skimping on the kind of details that used to help them recall what they were treating you for and why they tried one thing and why something else didn't work.

They've also done studies that show that when a doctor has a paper chart in his hands, he tends to read it all. With the EMR, your doctor tends to look at the most recent stuff that is on top and not read back into your history as much as they might with a paper record. That makes me uneasy. What if they miss something they need for your care?

Not to mention that electronic medical health records also can be HACKED and have been. Your nice medical info, pirated away for someone to steal your identity. Not a good thing.

However, the federal government is going to start fining doctors' offices that don't do the EMR, which is why they are all doing it or about to now.

Luckily for my profession, there are systems that allow the doctor to dictate and for us to transcribe it right into the EMR. A good transcriptionist has an error rate of 1% or 2% and we have a QA process that helps insure that we do the very best work. Doctors putting their own stuff in means that only the doctor is looking...and catching your own mistakes is much harder than finding someone else's.

[Julie]

Just curious what the EMR has to do with office renovation?

[Slinky]

Nothing. Other than they've all happened at once. And - our government has been providing money to doctors and facilities to switch to EMR.

[DoriC]

Our Dr's practice just put in a new system which is pretty nice. If I have a question that's not an emergency, instead of waiting all day for a callback at the end of office hrs or sometimes not until the next day, I am now put through to his private inbox where I can leave my question and his nurse checks his messages several times a day, gets an answer from him and calls me back usually within the hour. @Slinky, Hmm, just because he changed the "decor", why did he have to change staff too?

[Slinky]

I don't know why, Dori. Its like he's going thru his second childhood w/all these new toys - and staff.

He doesn't seem changed - but everything around him in that office does! Sheesh!

Maybe the guvment gave him so much money to upgrade he had to find a way to spend it??

[zoocrewphoto]

I really like my doctor and her staff. I think I started going to her about 15 years ago. My mom was already going to her and liked her, and my old doctor had moved away. Back then, her office was in a larger building where several doctors had their own section, and the waiting room for everybody was in the center. It was about 20 minutes away, and it was okay.

About a year after I started going to her, she bought a home a remodeled it to become a doctor's office. It was much closer to her home, though further away for us. She did have to get a new nurse a few months ago, as the long time nurse had some health issues and I believe retired. But the two office gals are the same ones I have seen all the time. I can call and say my name, and they know who I am, and what my basic issues are. I don't have to sign in when I arrive. They see me, chat a little, if not on the phone, and I am usually in within 10 minutes of my appointment time. Sometimes early as my usual appointment time is 2pm, and they have lunch from 1-2pm. So, they sometimes go ahead and take me in at 1:50 even though they could still be on lunch.

The remodel was done very nice. They have 3 exam rooms, a nice waiting room with toys and a tv/dvd player in one section for kids. The office ladies are basically behind a half wall that stops just above their desk level. You can tell that there is a break area behind them and around the corner. It's a very warm and welcoming atmosphere, and it is worth the longer drive and staying on the ppo plan. My employer offers a cheaper plan, but I wouldn't be able to choose my own doctors. My doctor does still use the paper records, which is fine. She refers back to various pages for what and when I have had issues. She was able to look at the inside of the folder to see when i last had a tetanus shot as I asked about the whooping cough vaccine, and they now come combined with the tetanus shot. Mine was too old, so I got a new one.