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Physicians sacrifice a lot to deliver care. Technology shouldn’t ask for more.

Erin Palm, MD, MBA
Tech
December 4, 2018
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I had a great case the other night. Around midnight on a Friday, the hospitalist physician called me to evaluate an incarcerated femoral hernia. I thought this elderly and medically ill patient would likely die no matter what I did. I spent a grim half-hour at bedside explaining the dilemma to the patient and her family. She needed surgery, but surgery would probably kill her.

The patient chose surgery. And she lived. In fact, ten days later she was home with her family.

Practicing medicine is deeply satisfying, even when it’s hard. Perhaps especially when it’s hard. Sleepless nights, skipped meals, difficult conversations with patients and their families – this is literally what I signed up for.

At every juncture I ask myself, am I doing what’s right for the patient? That is the essence of medical professionalism. Even when it means putting my own needs aside.

But that being said, physicians are human.

I could tell this story another way. I work two jobs. My full-time job is at a technology start-up. I practice surgery and critical care medicine mainly on evenings and weekends. I get to do two things that I love, but it’s demanding. That Friday, I went from a morning of meetings to the hospital in the afternoon. I operated into the evening and was hoping to get some sleep overnight. Because if I sleep overnight on Friday, I have more energy to hang out with my kids on Saturday.

But then I got that call from the hospitalist physician. For a brief moment, I felt disappointed about not sleeping. A human response. Then my professional conviction gained momentum, and the only thing I wanted to do was the right thing for the patient.

As I talked the family through the damned-if-you-do and damned-if-you-don’t decision about surgery, it would never have crossed the family’s mind that I was tired or wanted to sleep. Sometimes there’s no place for my needs. They needed confidence in my ability, and I brought my A-game. That’s why it can be hard for people to think of their doctors as human. We don’t want patients to see us as vulnerable or fallible. It helps if they see us as superhuman.

Physicians are committed and selfless professionals. But we also have families, pets, homes on our minds. We get tired, we get hungry, we have to take bathroom breaks in the middle of long surgeries. We feel angry or hurt when patients are rude to us, but we care for them anyway. We feel frustrated and annoyed when administrative requirements bog us down, but we put it aside and carry on. We tolerate a lot to do what’s best for patients.

That’s why a little thanks in medicine goes a long way. For instance, it’s lovely to talk with grateful patients and families. It’s downright pleasant when nurses recognize I’ve gone out of my way to be available or accommodate a small request. I appreciate when a fellow physician calls overnight and apologizes when my groggy voice reveals she has woken me up. She probably has a good question, and I’m happy to answer – but it’s thoughtful to acknowledge I have human needs. All this makes me feel appreciated.

While I do feel that kind of appreciation in many individual interactions, the health care industry itself seems to appreciate physicians less and less. Changing policies, payment, and clinical demands only seem to consider the patient and payer perspective, rather than the physician impact. And, perhaps most importantly, new technology requirements and solutions meant to “transform” health care instead burden physicians with administrative headache.

Today’s doctors are burdened with huge administrative and documentation demands and have to contend with difficult-to-use electronic medical records (EMRs). On average, for every hour spent with a patient, physicians spend nearly two additional hours on medical paperwork. And, a July 2018 survey from athenahealth found that 37 percent of providers spend more than 10 hours a week on medical documentation outside of normal business hours.

It’s clear that physicians are willing to sacrifice for their profession and for their patient. But struggling through EMR interfaces to do data entry takes time away from patient care.

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On that Friday night, as soon as we decided to go ahead with surgery, I had to leave the patient’s bedside to log into a computer. I needed to submit a case request, day-of-surgery orders, a consent form, and a note in the EMR. The OR staff wouldn’t be able to start the case without them. The irony, having to leave the patient to move her care forward.

Technology clearly has more to offer. Why should an EMR be any harder to use than an iPhone? “Hey Siri, create an add-on case request for Mrs. Jones.”

I love surgery. I am often willing to put my own needs aside to do what I love, and help a patient in need. I would do it for the intrinsic rewards, even without thanks. Appreciation from patients, families, colleagues, administrators, and occasionally random strangers makes the job even better. It’s a nod towards the doctor’s humanity – not required, but more than welcome.

Along the same lines, technology made for doctors would be a breath of fresh air. A statement that someone cares. I know it can be hard to understand the person behind the professional image. But we’re just like everybody else: we want technology that works. It seems silly for doctors, in 2018, to be working with EMRs that range from inefficient to unusable.

We need tools that support us and fit seamlessly into our work. Technology has great potential to transform health care – if it empowers rather than distracts, slows, or restricts doctors.

Practicing medicine can be deeply satisfying even when it’s hard, even when it’s done without thanks. If the EMR is burning you out, don’t give up. You deserve better from technology, and “better” is coming.

Erin Palm is a general surgeon and director of product, Suki.

Image credit: Shutterstock.com

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Physicians sacrifice a lot to deliver care. Technology shouldn’t ask for more.
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