Doctor Visit

Recently I had a routine checkup with my primary physician and I was surprised. The office visit protocol had been completely revamped.

For all the years I went to the doctor in Connecticut and then when I started with new doctors here in Santa Fe, a medical office visit was a 15 minute session after a 40 minute wait in the waiting room.

The doctor would come in, exchange pleasantries, then sit down at his computer and read my history, study the last visit notes, medications, etc., focused on the screen and only occasionally interacting with me to confirm what he was learning. 

After that -- the last 8 or so minutes of the whole visit, he would turn to me and we'd discuss current issues, my questions, and he'd do a brief exam. 

Then, pleasantly ushered out the door with some new prescriptions or referrals, I'd be done. The laptop was updated. I was processed.

But this time the first thing I noticed was a white board at the reception desk with doctor's names (it's a big practice), whether they were "on time" or running late, or out of the office. It looked for all the world like an airport terminal flight board. 

I checked in early, and was immediately called into the examining room. Not even five minutes were spent in the waiting room trying to ignore what was flickering on the wall TV. After the nurse did my vitals, I waited in the exam room a bit and the doctor walked in.

Surprise! He did not walk over to the computer. 

Instead he sat directly across from me, looked at me, and began to talk to me (TO me!) about what had occurred at my last visit. He knew what I was taking, knew what my complaints were and we discussed updates to my condition. He was aware of everything in my record, even the fact that my grandkids share their runny nose colds with me each time I see them. 

He knew my history before he walked into that room. He knew my eosinophil levels and why they were a worry.

Obviously he doesn't know me or recall any of this, he got it all from my chart. But he had familiarized himself with all of it before he even started the office visit. He did not spend half the exam time scrolling through screens of my medical records while I waited there for him to finish up and start the visit. This time the doctor came in totally prepared.

I felt seen. I felt known.

The new office procedures were clearly scripted as a new way of doing things, even though the upshot of my exam was the same as always -- a prescription change, confirmation of what I needed, flu and covid shots administered, and some friendly pleasantries. 

But what a difference it made in how I felt. 

I remember when patients were never allowed to see their own charts, and you had to take notes while sitting there undressed to have any chance of remembering what the doctor said or what your prescriptions were and how to take them.

Now as you exit the clinic, you get a printout of the visit, including notes, your next visit, what medications you're on, dosages, phone contacts for referrals, and next steps. It's all online too, along with all your inscrutable bloodwork numbers and grainy x-ray photos.

But the biggest improvement for me was the simple revamp of office visit procedure to have the doctor walk in knowing something about the patient in advance, have the doctor ignore the laptop sitting there on the counter, and sit down and talk to the patient.

Wow.