You call to schedule an appointment, and you're offered 3 different possible dates and times, all Way Too Far away, and all 3 of course during one of your important I-really-can't reschedule work meetings (which, of course, you do reschedule, because how else would you EVER actually finally get in to see this doctor?). You take an appointment and block out half your day to accommodate the office visit (they're always running behind), parking ($16 to get trapped in a half hour of an underground traffic jam), and of course the commute itself. Highlighted in bright orange on your calendar, you can't miss this appointment from 10 miles away, which is about how far you'd have to walk to the appointment if you don't forfeit over the $16 parking fee...
The day of your appointment arrives. You got stuck in the Lunch Rush traffic, got a frustrating phone call in the car, and now you're finally signing in--barely on time--with the receptionist. As you're waiting, you struggle to put out the fire that frustrating phone call was related to by as swiftly as possible composing emails, which you proofread with great anxiety and look at your watch.
You're hungry. You skipped lunch to see this doctor. Also, you have to pee. You look at the exit door, then back to the receptionist, believing with all your famished heart she will summon the doctor the very instant you leave for the restroom and banish you from the office if you try to return to your Missed Appointment.
While you're smack in the throes of this decision-making quandary, a nurse calls your name, and you are soon left in a freezing 4x6 cell-I-mean-exam room to wait some more. Between your work problem and the diagram on the wall across from you comparing a healthy colon with real photographs of distinctively unhealthy colons, you begin to worry. You're not even seeing the doctor for your colon. You're seeing her for--
IN walks your doctor. A brief introduction, a freezing cold handshake, the same questions the nurse asked you, and then--
A BLUR. Something something. Nods. Yup's. Something something. And then she's gone.
Just as the door closes behind the doctor--the one you missed both lunch and that I-can't-miss-this-meeting meeting for. Dejected, you leave.
At least you can go pee now.
Let's face it. Doctor visits are fast and furious. And not just for you. Imagine being the MD, seeing patient after patient after patient, with only 12 full minutes allotted per appointment in each freezing cold cell-I-mean-exam room. Charts are skimmed, questions are limited, and explanations are brief at best. Efficiency, best treatment, and attaining that nebulous "friendly bedside manner" are all competing priorities. You think YOU'RE stressed...
What if you could go back and ask the physician her impression? What if you could see her rationale on paper for your diagnosis? What if you could have in writing that treatment plan she breezed through with you?
Maybe you already have this luxury. In fact, over 5 million patients now have access to their physician's notes through a program called OpenNotes. Some leading centers that provide OpenNotes are Beth-Israel Deaconess, Mayo Clinic, and Cleveland Clinic. Beyond the typical patient portals of today's major medical facilities that offer access to your lab results and direct office email features, OpenNotes allows patients to see that important document developed by the clinician that helps him or her monitor and evaluate their patient and communicate with other providers all relevant medical information about their case.
Patient access to clinician notes is a good thing. A really good thing! Boston's Beth-Israel Deaconess Medical Center's Dr. Sigall Bell, reported by MobiHealthNews' Jonah Comstock yesterday, just published results on 5 years' worth of data evaluating effects of OpenNotes on quality care and patient safety and concluded that patient access to clinician notes improved patient adherence to treatment, helped prevent physician prescribing errors, and enhanced patient-physician dialogue. Patients were diagnosed more quickly and had better coordination of care with other providers too. Thumbs up for safety and quality. Efficiency, accuracy, warm alliance: CHECK!
What does this mean for you? If you have ready access to your doctor's notes, read them! Be an engaged patient, knowledgeable about your own body and your treatments and your #1 advocate for your health.
If you don't have MD notes at the click of your fingertips on your patient portal, you can still be engaged. Unlike the patient above, distractedly stressed over work and doing the pee pee dance during her appointment, you can collect the important pieces of info you need and maximize your time with your dialogue with these 3 simple tips:
1. Bring a notebook with your specific questions and symptoms. You don't want to leave the office and remember an important question you meant to ask or symptoms you meant to mention. Come prepared. Part of coming prepared is:
2. Do your homework. Is your question a basic one that you can easily answer with reliable online sources? In researching before your appointment, you'll likely not only answer some questions you have, but you might learn more and uncover new, more focused questions for your doctor to answer.
3. Take notes! Especially keep track of your treatment plan and followup plan. One of the benefits of OpenNotes is that patients who use it stick with their followup plan better--probably because they had their doctor's note as a reminder. You too can record these important notes.
What about your dietitian? What can you expect if you work with me?
Knowledge is power, and my aim is to empower you! Following each appointment, you will receive a copy of my notes on the consultation as part of your medical record with me. You'll have my notes on what topics were discussed, ideas for change, skills practiced, and our education points. Especially important on these notes will be your objectives that we discuss and the specific goals you set.
Just as OpenNotes would have helped our frazzled friend above, my provision of your notes will help ensure that you and I are getting the very most out of our time together, and that we are together on the same page--literally!