What is the impact of new technology on patient-physician communication?
The theory: A generation ago, the phone and fax machine were the means through which patients and physicians conducted their remote communications. That is no longer the case. A 2009 study found that more than 80 percent of Americans seek health information online.
The application: Electronic patient portals and social media both present unique opportunities for patient
engagement. They also can be landmines for breaching patient privacy and unprofessional behavior. The chapter recommends a brief set of do’s and don’ts that physicians should heed in both their personal and professional online communication: do respect patient confidentiality; don’t blur professional boundaries; do be open about conflicts of interest; and don’t make abusive or gratuitous comments about individuals online.
Why it matters for medical trainees: There are more ways for patients to contact physicians, and physicians need to contextualize those venues.
“Physicians need to be aware of the boundaries and that it is our responsibility to keep the patient information safe,” Dr. Grethlein said. “We can think about patients who reach out to their doctors on Facebook, and I try to compare that with the patient who comes and sits next to their doctor in church. That is not in the doctor-patient typical relationship, and if managed well with appropriate boundaries you might find a way for that to work. But you shouldn’t be conducing medicine in church and you shouldn’t be conducting medicine on Facebook. Those are not private venues.”
Why the renewed emphasis on teamwork in health care?
The theory: If health professionals across disciplines are not functioning as an effective team, a patient’s quality of care will suffer.
The application: Health systems have formed units, such as accountable care teams, that are designed to strive for the best clinical, service and financial outcomes for a patient. In addition to physicians, these teams consist of members from a number of different fields—such as case managers, pharmacists, nurse specialists and nutritionists.
Why it matters for medical trainees: While physicians are used to being at the top of the leadership structure in a hospital, that may not be the case in this type of structure.
“As a physician … the perspective of people other than me is important,” Dr. Grethlein said. “I may not know to think about the cost of something or that a certain medication needs refrigeration, but the social worker who knows that the patient doesn’t have stable electricity in their home or can’t afford the bus fare to get back to see me for a follow-up appointment is just as important in caring for that patient as I am for prescribing that right medication. I can prescribe it all I want. If they can’t get it because it costs too much money, then I haven’t really served the needs of the patient.”
Health Systems Science is now being used in 14 medical schools across the country, including seven that are not part of the AMA Consortium. The book retails for $59.99 and can be ordered from the AMA Store and the publisher, Elsevier, as well as from Amazon and other online booksellers. AMA members may order it from the AMA Store for $54.99. Individual chapters are available from Elsevier’s Student Consult platform for $6.99 each.