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Thursday, November 6, 2014

Small talk and small things

November is a packed month:


  • I'm in Saudi this week, teaching people how to teach others what we have been doing for the past two years.
  • Next week is the IHE Technical Face-To-Face Meeting
  • Following that, I'll be headed to AMIA for my first time (as a Student)
  • I have a term paper due shortly.
  • Boxes still have to be unpacked, and I need to remove leaves from more than an acre of property.
My move is complete, and we are quite happy with it (when I'm there).  School is going fairly well. I've got two courses this semester, Scientific Writing, which I love, and Introduction to Biostatistics, which I'm also enjoying.  So far, both classes have been pretty easy for me, although I seem to want to make my writing class harder than it needs to be.  The same is probably true for by Biostatistics class.  But I have allocated the time for these classes, so I'm pushing myself to learn as much as possible in them, even if that goes beyond the curriculum set.

One of my current challenges is finding a doctor for my family in my new home town.  I have some criteria they have to meet:
  1. They absolutely must have a patient portal.
  2. The should have an office within 15 minutes of the house.
  3. They probably should be in my home state (Massachusetts), even though I'm two minutes from Woonsocket, Rhode Island.  The rationale for this is that the hospitals that I would want to go to (or have a family member in) if need be are both in Massachusetts, and that makes things a lot simpler.
  4. What I read about them online should be positive.
  5. If possible, I'd like them to be in a physician group large enough to include the variety of specialties that we've used in the past, including pediatrics, orthopedics, gastroenterology and ob/gyn.  In addition, with my mother living with us part of the year, I'd also like them to have someone in the practice that specializes in gerontology.
The biggest challenge has been finding a physician who meets this criteria and who is taking new patients.  So far, I've been striking out.  Technology doesn't help much for a patient in this situation.  My health insurer's information is insufficient.  They have little about the availability of a patient portal, focusing only on Physicians who work with their own Health IT product, and not reporting about portals supported by anyone else, and they say nothing about whether or not the physician is taking new patients.  And taking new patients is a dubious term when at least two physicians who are "taking new patients" don't have an appointment for more than four months out.  

The last time I changed physicians was with my last move, and it was easy.  I picked up the phone and called one, and they made an appointment for me.  But back then, I lived a heck of a lot closer to Boston, a major city with a serious medical industry in it. Now I am learning what it means to be living in a rural area, near smaller cities, and being stuck with the choices that many are stuck with.  I've also set a much higher bar this time than I had the last time.  Fortunately, I can probably go another three months before I need to have a new physician in place.

This is definitely a first world problem, and it gives me a new found understanding of what a physician shortage might actually look like.  Frankly, for me and most of my family, and our health issues, we don't much need a physician.  I've been thrilled with the care that my children get from their NP, and would be just as happy with an NP or PA for most of my ailments.  By the time it gets serious, I would need to see a specialist in most cases, and it's been pretty obvious even to me what kind of specialist I need.

There are a lot of big problems in healthcare.  This is a small one.  An annoyance.  But I wonder why I have to put up with it, and the many other small annoyances that come with our healthcare system in this country.  We tend to focus on the big things in Healthcare IT, but what if we paid attention to the myriad of small things somewhere?  What would be the economic impact of that?  For most of my life, the cost of those small annoyances probably adds up to a significant amount in terms of my time and money.  Telemedicine just became an option for me, and so I'm thinking about exploring the possibility further.  

And I'll also be thinking a good bit about how Health IT could be addressing those small problems for patients as well.

   Keith

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