The recent news about DNA got to me the other night, so much so that it woke me up in a cold sweat. Now that the DNA sequencing can pretty much figure out the entire population of the US, is nothing sacred anymore? Facebook and Google know everything that we are up to on the planet because we let them. It’s great for catching bad guys, but most of us aren’t serial killers. One positive thing did happen; it did get me to reflect on one thing my medical practice has to offer: privacy.
I am offline and off the grid. I am not on any insurance panel. I have opted out of the requirements that bind me to the Centers for Medicare and Medicaid. I don’t even have an electronic health record system. For those of you that don’t know, every since switching from “old school” paper charts to electronic medical records, we in the healthcare field have placed all of our patient’s health information on a cloud somewhere. I remember writing paper charts in medical school, never thinking anything fantastic about them, but how they gave me hand crams. Honestly, there is something to knowing that my records that are on my computer don’t go anywhere else. I do use a laptop and I have word document, so I’m not that old school. But, there is a human connection when I print out the history form and sit down with someone and write down their life story on ink, rather than staring at a screen and cursing at software changes and missing the subtleties of a person’s life—what they say and what they don’t say.
But back to privacy—why not demand your health records to be private? Well some may say, “I have nothing to hide. I have no diagnosis that’s worth anything, so I don’t care”. But some people may have sensitive history that they don’t want anyone to know, and should they not have the option to be “off the grid”?
Not only are my medical charts off-line, a patient could even go further to keep the transaction in all cash. And did I mention that if you needed a prescription from me, that’s paper only, too?! “When was the last time you saw a paper prescription that was hand-written?” was what one of my attending’s told me last year, as if it was a relic of the past. In the medical school world these days, paper prescriptions are the equivalent of someone handing in a cursive manuscript in English Literature.
Another step further, if you actually go to an independent pharmacy, they should be able to honor your privacy more so than a national chain.
Okay, that’s well and all, but one final point. In addition to privacy, the above-mentioned “efficiency ” of electronic health records, electronic prescriptions, dare I say it, even insurance, (which is so inefficient in the first place)—the entire technological infrastructure that we have created in healthcare—just costs doctors more money. That money trickles down to you as a consumer. As a business model, especially in primary care, we do not need all the bells and whistles to care for the majority of primary care complaints or health needs. In the end, my unloading this entire “grid” gives you, the patient, more bang for your buck with me. And it gives me, the doctor, more time to take that phone-call on the weekend for chest pain and prevent someone from unnecessarily going to the Emergency Department!
Are there things that you don’t share with your doctor because you are worried about your health security? Don’t share them here. Email me. Better yet, just call!
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