This is a finalist in the 2016 STFM Student Blog Competition.
Clickity click click clack. I smile to myself as I recall the days I was a medical student, like the one sitting next to me now. Monika’s eyes intently focused, she skims the electronic records for our patients. The names are all so familiar to her, because she has seen them often with the real-time data we receive from them. Gone are the days of visits that occur every few months; we “see” our patients all the time. The definition of quality care in family medicine—patient-centered, values and evidence-based, efficient—is still intact but has been chiseled to include new dimensions.
The consideration of time as a limiting factor has not lost its grip in health care. People are busy. They work varied schedules, sleep at odd hours, visit their grandchildren, water their plants, and drive to appointments. But with the ubiquity of health tracking applications, providers now have the ability to take a peek at an individual’s health status on a regular basis. Triage at the clinic receives some alarming information—Roger’s blood pressure has been through the roof the past few days. Hmm, did he forget to refill his meds? Do we need to finagle his medications and dosing to better manage his hypertension? Are there unaccounted for stressors affecting Roger’s changes? With the wave of data that is available at our fingertips, changes in health care have focused on transferring information from patients to providers in real-time. Medical personnel have an allotted amount of time to work through acute health issues as they arise, in the same way health centers leave open time slots for “day of” appointments.
With dedicated staff sorting through data from our patient pool, providers are kept abreast of issues that need urgent attention. Simultaneously, we are able to respect the immutable facts of life—patients, especially when ill, have a difficult time coming to clinic. They may feel weak, fatigued, or simply have no one to drive them to a last minute appointment. By connecting with patients via phone, email, or other online messaging, the dynamics of power have shifted. It was simply a fact during my medical schooling that patients came to me. They entered within the walls of a room that were not all that welcoming, a little cold and definitely not as cozy as their living rooms; simply put, they were on my turf. Some visits are held at the clinic, while other health discussions are based out of patients’ homes, where I call them at a mutually agreed-upon time. Patients are reassured that they can lean on me as a source of knowledge, while feeling the pulse of their own autonomy.
Moreover, people are often excited with the newest technology, allowing them to be in control of their health in ways that might have been scoffed at decades ago. Technology is readily available and cheap, and made even more affordable through tech and medical partnerships. Patients now have the ability to rely on gadgets to track their blood sugar or take their blood pressure without a second thought. The patient and providers are alerted if health parameters fall out of a certain range, but relatively hands-off tracking methods have provided the opportunity to spend precious time enjoying life, rather than fidgeting with thrice daily needle sticks. Incorporating mobile applications and high tech devices into family medicine has also turned the tide further toward preventive medicine. With patients receiving direct feedback regarding their health, they become finely tuned to understand the push and pull of their body’s homeostasis. Potentially burdensome health conditions can be caught early, as medical staff counsel patients on altering the course of disease progression.
The greatest shift in family medicine in the past decade has been taking advantage of the resources that abound. Technology may not be the panacea we yearn for, but it is an impactful tool to be used wisely and creatively. As medical providers, our ideas for improvement can sometimes get trapped within the walls of our clinics. But in order to continue engaging patients and molding quality medical care into the confines of daily living, we strive to keep up with the spirit of the times—or risk leaving health and wellness behind.