How Technology Integration Has Altered Doctor/Patient Care in Hospitals (David Rosenthal, M.D. and Abraham Verghese, M.D.)
Over the past few years, I have compared physicians and teachers because even with so many differences in preparation and the nature of their work, they share two core principles. Both professionals belong to helping professions where their success, in part, is dependent upon the patient and the student. And success, however defined, depend upon each professional developing close relationships with their patients and students. The degree to which labor-saving devices have increased the efficiency of both physicans and teachers in carrying out their daily work, there are, nonetheless, tradeoffs that have become apparent as professionals practice in hospitals and schools.
The following article, “Meaning and Nature of Physicians’ Work,” appeared in the New England Journal of Medicine, November 16, 2016. To see citation, click on footnote number in NEJM article.
….Typically in our field, internal medicine, residents arrive at the hospital at 7 a.m., get sign-outs from nighttime residents, and conduct “pre-rounds” to see patients they have inherited but don’t know well, before heading to morning report or attending rounds. Attending rounds often consist of “card-flipping” sessions held in a workroom, frequently interrupted by discharge planning and pages, calls, and texts from nurses and specialists. Finalizing discharges before noon can feel more important than getting to know new patients. Increasingly, the attending physician doesn’t see patients with the team, given the time constraints.
No longer are there paper charts at the bedside. The advent of the electronic era, while reducing the time required for tracking down laboratory or radiology results, has not substantially changed the time spent with patients: recent estimates indicate that medical students and residents often spend more than 40 to 50% of their day in front of a computer screen filling out documentation, reviewing charts, and placing orders. They spend much of the rest of their time on the phone coordinating care with specialists, pharmacists, nutritionists, primary care offices, family members, social workers, nurses, and care How Technology Integration Has Altered Doctor/Patient Care in Hospitals (David Rosenthal, M.D. and Abraham Verghese, M.D.) | Larry Cuban on School Reform and Classroom Practice:
