If we want to make electronic medical records work, do we have to introduce a third party, a scribe, to arbitrate patients’ complaints about what the electronic medical record is doing to their relationship with their doctor?
My own view? You have got to be kidding me. The whole point of moving to the electronic medical record was to be efficient. Adding a third party introduces opportunities for error. That scribe will not be able to pick up a mistake while punching in information. The scribe may not realize, the way the doctor would, when the patient has said something inconsistent. Not to say that the doctor cannot monitor what is being said, but data entry by a third party is simply another way to introduce more mistakes and errors.
I fully appreciate the need to spend time talking with the patient face to face, and I do think patients are right to say, “I don’t want to talk to the back of someone’s head; I want to talk to my doctor.” But the answer is not to add a third party. It is to fight hard to make sure that we put a little more time into the doctor-patient relationship, and add a little more reimbursement into the doctor-patient relationship — use the machines to be efficient, but also compensate monetarily for what people say they want: face-to-face contact with the doctor.
A third party is a Band-Aid on a serious problem. We do not have enough time in medicine to pay attention and listen carefully when we are face to face with our patients. I believe we ought to fix that, rather than introducing another person, along with a new machine, into the doctor-patient relationship.