Last night, I ended up going to a local urgent care clinic because I had caught a bug that’s been going around here, and, seeing in others that the over-the-counter remedies have had little effect, I decided that I’d bite the bullet and go to the doctor.
The place I went to is part of a huge system in this state, although this location is pretty short-staffed. I noticed, from the get-go, that the number of questions the nurse asked about health history was pretty non-existent. Sure, I have a “record” with this system, but I don’t think I’ve had any sort of appointment with them for nearly three years, and I didn’t even get the question, “Are there any changes in your health?”
So we went through the appointment, and it turns out I have something similar to strep throat that isn’t actually strep, and the doctor and I were going over a couple of options for medication, and he left. I thought it was a little odd because with women, in particular, there are certain times where certain medications are not supposed to be prescribed, but I never got anything like any of those questions until the doctor popped his head back in to ask if I was nursing or if there are small children in the house. I told him the piece of information that I suspected he should know, and he said, “You should have told me that before!”
My guess is that as electronic medical records have taken over, doctors and nurses are getting more reliant on checking these rather than taking the time to talk to people, especially in situations where locations are short-staffed. (Furthermore, it’s the type of area where there was a poster on the wall telling people that, first of all, antibiotics will not be prescribed in most cases of cold symptoms and secondly, please don’t pressure the staff to get them prescribed to you.) To some extent, it makes sense; if the nurse and/or doctor can get an overview of health history, it can often be helpful and save time. On the other hand, to skip the formalities of asking some of these questions because they are relying on the electronic histories to tell them more that the patient can also be dangerous.
In the end, the doctor ended up changing the prescriptions completely, to the degree that I wasn’t even sure how many I was picking up afterward. I’m home and feeling somewhat better, though still definitely in the category of “sick”. I’m grateful to have available health care. I’m glad for the medicine and 24-hour pharmacies.
Yet, in many ways, where “progress” has been pushed, there’s something that’s been lost, and it’s not always obvious. Electronic medical records, for example, are a good idea in theory. They’re uniform, legible, and portable. On the other hand, when things are online, there are the issues of privacy and theft, for example. Furthermore, electronic medical records don’t necessarily get held as long as paper records did, resulting in many losing records completely. (Retention of medical record laws by state.) Not only this, but when things get entered in incorrectly – which happened to one of my kids – it’s a HUGE pain to try to get corrected, because in many cases, there is no record of who made the error in the first place, so even if the mistake is glaring, getting it changed is like fighting city hall.
Call me silly, but I hadn’t even considered issues about medical records until my 20s, when I accompanied a friend of mine (in the olden days) who was moving and who had some serious health issues to the doctor’s office. She was picking up her medical file. The thing was about 3/4″ thick, and, while most of the pages were held together by the record folder’s posts, there were also pieces of paper sticking out of it. She’d be bringing it to her next doctor in her new city. Obviously, this isn’t optimal, but on the other hand, before we all go worshipping “progress” for progress’ sake, we ought to make sure we’re not losing things unnecessarily.