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A tale of two visits

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George Saunders wrote, “Irony is just honesty with the volume cranked up.” Last week I got a heavy dose of irony and the amp was turned up to 11.

The one thing I despise more than retail shopping is doctor appointments, yet I recently had two of them on two consecutive days. All was not lost, however. I was preparing my upcoming podcast interview of Dr. Eric Topol about his fascinating and groundbreaking book, “The Patient Will See You Now,” and guessed that I could get about half of it read while waiting for the forever “running late” doctors.

The two appointments could not have been more different. At one extreme (the present), the first appointment represented the paternalistic patient-as-a-byproduct system to which we are all too accustomed. It was bogged down by duplicative systems, paperwork and inefficiency. The second exemplified the beginning of the very future Dr. Topol predicts.

Although I am a long-time patient, the receptionist handed me a clipboard with eight or nine sheets of paper and a ballpoint pen from a local eatery. When I suggested (complained?) that they already had all of this information in their files, I was told, “It wouldn’t transfer to the new system.” What? You have paper and you are making me create more paper so you can key it into a “new system?” At least I didn’t smudge my fingers on any carbon paper. Madness!

Then I committed the ultimate indiscretion. I asked if I could have a copy of the forms. They were surprised at the question but trotted off to “ask the office manager.” The answer was straight out of Topol’s book. “No,” I was informed, “the forms are the property of the practice and this information is not provided to patients.” I protested that it was my information but they would have none of it.   

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I completed all of the paperwork (some questions were repeated four times) and waited nearly 45 minutes to be seen. The nurse practitioner I was seeing asked me every single one of the questions on the forms I had just completed. When I asked why they were doing this a second time, she said that (I am not making this up) the forms I filled out in the waiting room were going to data processing and these forms were for my patient file — the one I couldn’t have a copy of.

Sadly, this is an all-too-believable reality.

The second appointment, however, was the future. I was a new patient and as I walked in the door I was welcomed and handed an iPad to verify the medical information I had added via their secure website prior to my appointment.

I held my insurance card up to the camera when prompted and at the end of the process the app announced that it had automatically populated both the office’s information system and my secured online account, which, it said, I could access and update any time I wanted, from the convenience of anywhere with Internet.

Oh yes, they would also appreciate it if I would use the app to make my next appointment, too. No need to call … their calendar was interactive.

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Having back-to-back past and future-oriented doctor’s appointments while reading Topol’s book was quite a coincidence. The two visits underscored his message perfectly. Perhaps, as a different British author, Jaqueline Winspear, wrote, “Coincidence is a messenger sent by the truth.”

I will be posting a podcast featuring an interview with Topol soon. His book is a great read as well and I would highly recommend it as a first-class view at a future that has already begun happening. A future in which you and I (and our clients) will be in charge of our health care.