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(Some Blog)   Because asking sick patients to enter their own case histories and symptoms in the electronic record before the ER doctor sees them will NEVER lead to gaming the triage system. At least the doc won't have to pay a scribe or *gasp* do it themselves   (kevinmd.com) divider line
    More: Stupid, Hospital, Patient, Patience, patient scribes, Physician, Abdominal pain, Medical terms, emergency department  
•       •       •

590 clicks; posted to Geek » on 14 Apr 2019 at 10:48 PM (5 days ago)   |   Favorite    |   share:  Share on Twitter share via Email Share on Facebook   more»



40 Comments     (+0 »)
 
View Voting Results: Smartest and Funniest
 
5 days ago  
Outsourcing gone amok.
 
5 days ago  
Somehow, I suspect a trained medical professional could tell the difference between "OMG I have pain and need to be given oxy stat!" and legit self-reporting.
 
5 days ago  
One day while on shift in the emergency department, I looked out into the waiting room at the dozens of people waiting to be seen. Many had been waiting for hours.

In my experience ERs don't work that way. I've taken my mom to the ER many times and she's never spent more than two minutes in the waiting area.
 
5 days ago  
Oh fark off.
 
5 days ago  
My dick fell off. Can I go first?
 
5 days ago  
This could be a huge step forward in health care administration! Specifically, hospitals can now start blaming all therapeutic errors on the patient, instead of hospital staff. Just think of it! Did grandma die from receiving the wrong dose of medicine in the ICU? We can just cite incorrect information on her intake form, thus giving us indemnity from lawsuits! Confusing language on obscure medical conditions (none of these proles will know what hypobilirubinemia is) will guarantee we can get a wrong answer we can point to in the courtroom. Bonus if we use tablets that are confusing to the elderly or have perpetually low batteries!

Now if you'll excuse me, I have to tee off in 20 minutes
 
5 days ago  
img.fark.netView Full Size
They pioneered a similar system to this at Saint God's in a few hundred years.
 
5 days ago  

Fabric_Man: This could be a huge step forward in health care administration! Specifically, hospitals can now start blaming all therapeutic errors on the patient, instead of hospital staff. Just think of it! Did grandma die from receiving the wrong dose of medicine in the ICU? We can just cite incorrect information on her intake form, thus giving us indemnity from lawsuits! Confusing language on obscure medical conditions (none of these proles will know what hypobilirubinemia is) will guarantee we can get a wrong answer we can point to in the courtroom. Bonus if we use tablets that are confusing to the elderly or have perpetually low batteries!

Now if you'll excuse me, I have to tee off in 20 minutes


It is called an encounter/patient history form.

There is no difference than handing you a tablet, or the traditional method of handing you a clipboard with a couple of sheets asking you take check off illnesses/you may or may not have.

It being done digitally is ultimately more efficient and saves waste on paper.

In the paper situation you fill out the form, the office worker tosses it in your file.  The doctor looks it over, might ask you some questions about it.

Now it all done on tablets.

And it takes the middleman out of it.  The patient no longer can say"well, that girl at the front desk must have changed it."
 
5 days ago  
How is doing it digitally on a tablet different from this?  It is not. Patient still fills out out.

printabletemplates.comView Full Size
 
5 days ago  
Why do we have this sudden influx of people with chest pain and allergies to everything except morphine?
 
5 days ago  
It says here you have butt spiders.
 
5 days ago  

theflatline: How is doing it digitally on a tablet different from this?  It is not. Patient still fills out out.

[printabletemplates.com image 723x1024]


The patient history questionnaire is one thing.  This guy wants the patient to essentially perform and report the physical examination.  A patient who might have a reason to exaggerate their symptoms to be seen sooner, or who might not have the education and training required of the medical scribes who do the job when the doctors don't do it themselves.

His complaint is that he doesn't like doing an essential part of his job and doesn't want to pay a professional to do it for him.  Maybe he should find another line of work.
 
5 days ago  

Chariset: Why do we have this sudden influx of people with chest pain and allergies to everything except morphine?


Don't be allergic to morphine either.  I'm not, but it does cause me enormous amounts of digestive/elimination issues, thus it's pretty contraindicated unless I'm dying and it's all you have.  Dilaudid on the other hand works fine.  Now, combine that with a pain condition (RSD/CRPS) that sometimes reaches Defcon 1.  No faster way to make an ER doc/nurse suspicious than to have actual knowledge of how painkillers work on you, regardless of the reason you know.  Now, try explaining all that when you're having difficulty not screaming because it hurts so damn much.  It's a lot of damn fun.
 
5 days ago  
Describe your symptoms below:

I think it's Sphenopalatine ganglioneuralgia.


(FYI brain freeze from cold drinks or food. lol)
 
5 days ago  

common sense is an oxymoron: theflatline: How is doing it digitally on a tablet different from this?  It is not. Patient still fills out out.

[printabletemplates.com image 723x1024]

The patient history questionnaire is one thing.  This guy wants the patient to essentially perform and report the physical examination.  A patient who might have a reason to exaggerate their symptoms to be seen sooner, or who might not have the education and training required of the medical scribes who do the job when the doctors don't do it themselves.

His complaint is that he doesn't like doing an essential part of his job and doesn't want to pay a professional to do it for him.  Maybe he should find another line of work.


The way it is done now is the patient is asked questions by somebody when they get to the ER. That person then enters that into the record and the patient begins the wait period to be seen by the doctor.

Now:
Worker~ Where does it hurt?
Patient~ Abdomin
Worker~ How much does it hurt on a scale of 1 to 10?
Patient~ 8.

Proposed:
Tablet/phone~ Where does it hurt?
Patient~ Abdomin.
Tablet/phone ~ How much does it hurt on a scale of 1 to 10?
Patient~ 8.

In the way it works now, the worker isn't changing the answer to what he think it should be so there isn't any value in requiring him for all patients. The only value he brings is for patients who cannot or will not interact with the tablet/phone to enter their answers directly.
 
5 days ago  
Front of the line is easy peasy.  Just show up with a sack of potatoes slumped over your shoulder covered by a blanket and say you have a toddler experiencing respiratory distress.  Once you are in the room tell the doctor, "Well my potatoes are fine, but while you are here can you take a quick look at my leg?"

/I showed up to a half full waiting room with a 3 year old who had a tracheal tug and I didn't even need to stop walking at the front desk
 
5 days ago  

AliceBToklasLives: Somehow, I suspect a trained medical professional could tell the difference between "OMG I have pain and need to be given oxy stat!" and legit self-reporting.


It only takes 10 seconds before you're 86'd, especially when your symptoms sound textbook WebMD (hint to fakers: most people don't have all the signs IN ORDER)
 
5 days ago  

Benjimin_Dover: common sense is an oxymoron: theflatline: How is doing it digitally on a tablet different from this?  It is not. Patient still fills out out.

[printabletemplates.com image 723x1024]

The patient history questionnaire is one thing.  This guy wants the patient to essentially perform and report the physical examination.  A patient who might have a reason to exaggerate their symptoms to be seen sooner, or who might not have the education and training required of the medical scribes who do the job when the doctors don't do it themselves.

His complaint is that he doesn't like doing an essential part of his job and doesn't want to pay a professional to do it for him.  Maybe he should find another line of work.

The way it is done now is the patient is asked questions by somebody when they get to the ER. That person then enters that into the record and the patient begins the wait period to be seen by the doctor.

Now:
Worker~ Where does it hurt?
Patient~ Abdomin
Worker~ How much does it hurt on a scale of 1 to 10?
Patient~ 8.

Proposed:
Tablet/phone~ Where does it hurt?
Patient~ Abdomin.
Tablet/phone ~ How much does it hurt on a scale of 1 to 10?
Patient~ 8.

In the way it works now, the worker isn't changing the answer to what he think it should be so there isn't any value in requiring him for all patients. The only value he brings is for patients who cannot or will not interact with the tablet/phone to enter their answers directly.


Are you seriously suggesting that triage nurses are an unnecessary luxury in emergency rooms?

Again, there's a difference between the patient's history, which is obtained by the triage nurse, and their physical examination, which was traditionally dictated by the physician and is now often recorded by a scribe in the examining room.  This idiot wants to get rid of the latter because he thinks so little of his trained staff that he actually believes the patients themselves can do just as good a job, and of course he can't do it himself because he's a doctor, not a "typist."
 
5 days ago  

common sense is an oxymoron: Benjimin_Dover: common sense is an oxymoron: theflatline: How is doing it digitally on a tablet different from this?  It is not. Patient still fills out out.

[printabletemplates.com image 723x1024]

The patient history questionnaire is one thing.  This guy wants the patient to essentially perform and report the physical examination.  A patient who might have a reason to exaggerate their symptoms to be seen sooner, or who might not have the education and training required of the medical scribes who do the job when the doctors don't do it themselves.

His complaint is that he doesn't like doing an essential part of his job and doesn't want to pay a professional to do it for him.  Maybe he should find another line of work.

The way it is done now is the patient is asked questions by somebody when they get to the ER. That person then enters that into the record and the patient begins the wait period to be seen by the doctor.

Now:
Worker~ Where does it hurt?
Patient~ Abdomin
Worker~ How much does it hurt on a scale of 1 to 10?
Patient~ 8.

Proposed:
Tablet/phone~ Where does it hurt?
Patient~ Abdomin.
Tablet/phone ~ How much does it hurt on a scale of 1 to 10?
Patient~ 8.

In the way it works now, the worker isn't changing the answer to what he think it should be so there isn't any value in requiring him for all patients. The only value he brings is for patients who cannot or will not interact with the tablet/phone to enter their answers directly.

Are you seriously suggesting that triage nurses are an unnecessary luxury in emergency rooms?

Again, there's a difference between the patient's history, which is obtained by the triage nurse, and their physical examination, which was traditionally dictated by the physician and is now often recorded by a scribe in the examining room.  This idiot wants to get rid of the latter because he thinks so little of his trained staff that he actually believes the patients themselves can do just as good a job, and of course he can't do ...


The article said that this is to be employed during the waiting phase. That comes before the examination phase. Have you ever been to an ER?
 
5 days ago  

Fano: AliceBToklasLives: Somehow, I suspect a trained medical professional could tell the difference between "OMG I have pain and need to be given oxy stat!" and legit self-reporting.

It only takes 10 seconds before you're 86'd, especially when your symptoms sound textbook WebMD (hint to fakers: most people don't have all the signs IN ORDER)


Some of us also have OCD.
 
5 days ago  
If I go to the hospital ER, I've either broken a limb, I'm bleeding profusely, or I'm unconscious. You know, *emergency* stuff that can't wait.

Pretty much anything else I go see my doctor for, and if he says I need to go to the hospital for something, he will arrange me to be admitted.

People treating ERs like a doctor's office ("I've got the sniffles, I'm going to the ER") is a big problem, but I understand that it's like that because the ER basically can't turn you away even if you can't pay - a doctor in a private practice can.
 
5 days ago  
I'd do that if it would speed up the process but I bet I'd still be waiting an hour or more in the exam room anyway.
 
5 days ago  
I went to the ER the other week for some nasty bleeding and post-shock symptoms. I was there nearly 12 hours before I was seen. I probably could have gone to urgent care, but doctors/hospitals do a piss-poor job of educating patients on where you go for what.
 
5 days ago  

fusillade762: One day while on shift in the emergency department, I looked out into the waiting room at the dozens of people waiting to be seen. Many had been waiting for hours.

In my experience ERs don't work that way. I've taken my mom to the ER many times and she's never spent more than two minutes in the waiting area.


Where is your ER? In Memphis you're looking at a half hour to an hour on a great day, 2 hours or more depending on what's actually happening.
 
5 days ago  

fusillade762: One day while on shift in the emergency department, I looked out into the waiting room at the dozens of people waiting to be seen. Many had been waiting for hours.

In my experience ERs don't work that way. I've taken my mom to the ER many times and she's never spent more than two minutes in the waiting area.


Ahh, yes, the person who has taken his mother to the ER "many times" definitely understands how the ER works better than the emergency room physician who literally spends the entirety of his work day in an ER.
 
5 days ago  

Benjimin_Dover: common sense is an oxymoron: Benjimin_Dover: common sense is an oxymoron: theflatline: How is doing it digitally on a tablet different from this?  It is not. Patient still fills out out.

[printabletemplates.com image 723x1024]

The patient history questionnaire is one thing.  This guy wants the patient to essentially perform and report the physical examination.  A patient who might have a reason to exaggerate their symptoms to be seen sooner, or who might not have the education and training required of the medical scribes who do the job when the doctors don't do it themselves.

His complaint is that he doesn't like doing an essential part of his job and doesn't want to pay a professional to do it for him.  Maybe he should find another line of work.

The way it is done now is the patient is asked questions by somebody when they get to the ER. That person then enters that into the record and the patient begins the wait period to be seen by the doctor.

Now:
Worker~ Where does it hurt?
Patient~ Abdomin
Worker~ How much does it hurt on a scale of 1 to 10?
Patient~ 8.

Proposed:
Tablet/phone~ Where does it hurt?
Patient~ Abdomin.
Tablet/phone ~ How much does it hurt on a scale of 1 to 10?
Patient~ 8.

In the way it works now, the worker isn't changing the answer to what he think it should be so there isn't any value in requiring him for all patients. The only value he brings is for patients who cannot or will not interact with the tablet/phone to enter their answers directly.

Are you seriously suggesting that triage nurses are an unnecessary luxury in emergency rooms?

Again, there's a difference between the patient's history, which is obtained by the triage nurse, and their physical examination, which was traditionally dictated by the physician and is now often recorded by a scribe in the examining room.  This idiot wants to get rid of the latter because he thinks so little of his trained staff that he actually believes the patients themselves can do just as good a job, and of course he can't do ...

The article said that this is to be employed during the waiting phase. That comes before the examination phase. Have you ever been to an ER?


You rarely wait more than a few minutes to be triaged.
 
5 days ago  

GrailOfThunder: If I go to the hospital ER, I've either broken a limb, I'm bleeding profusely, or I'm unconscious. You know, *emergency* stuff that can't wait.

Pretty much anything else I go see my doctor for, and if he says I need to go to the hospital for something, he will arrange me to be admitted.

People treating ERs like a doctor's office ("I've got the sniffles, I'm going to the ER") is a big problem, but I understand that it's like that because the ER basically can't turn you away even if you can't pay - a doctor in a private practice can.


Your doctor works all weekend and all night?
 
5 days ago  

common sense is an oxymoron: theflatline: How is doing it digitally on a tablet different from this?  It is not. Patient still fills out out.

[printabletemplates.com image 723x1024]

The patient history questionnaire is one thing.  This guy wants the patient to essentially perform and report the physical examination.  A patient who might have a reason to exaggerate their symptoms to be seen sooner, or who might not have the education and training required of the medical scribes who do the job when the doctors don't do it themselves.

His complaint is that he doesn't like doing an essential part of his job and doesn't want to pay a professional to do it for him.  Maybe he should find another line of work.


That's not at all what he's talking about. He's talking about the job of the medical scribe who comes in after the triage nurse sees a patient to determine priority and before the physician sees the patient. The medical scribe simply records the symptoms that the patient states they are experiencing. It usually doesn't happen until the patient gets into a room and the medical scribes have very limited medical knowledge. They aren't RNs, they aren't MDs.
 
5 days ago  

GrailOfThunder: If I go to the hospital ER, I've either broken a limb, I'm bleeding profusely, or I'm unconscious. You know, *emergency* stuff that can't wait.

Pretty much anything else I go see my doctor for, and if he says I need to go to the hospital for something, he will arrange me to be admitted.

People treating ERs like a doctor's office ("I've got the sniffles, I'm going to the ER") is a big problem, but I understand that it's like that because the ER basically can't turn you away even if you can't pay - a doctor in a private practice can.


I managed to slice my head open pretty good a few weeks back, and instead of going to the emergency room, I went to one of those "doc in a box" urgent care centers. The nurse was suitably impressed by the cut, I got to see a doctor reasonably fast (it wasn't bleeding a lot, but it wasn't stopping), and he did a decent job putting in the dozen staples it took.

The total time from walking in to walking out was an hour, and the cost was a flat $299. Which also included another visit to have the staples removed ten days later. An ER visit for the same problem would have been several times more expensive, and the care wouldn't have been any better.
 
5 days ago  

theflatline: Fabric_Man: This could be a huge step forward in health care administration! Specifically, hospitals can now start blaming all therapeutic errors on the patient, instead of hospital staff. Just think of it! Did grandma die from receiving the wrong dose of medicine in the ICU? We can just cite incorrect information on her intake form, thus giving us indemnity from lawsuits! Confusing language on obscure medical conditions (none of these proles will know what hypobilirubinemia is) will guarantee we can get a wrong answer we can point to in the courtroom. Bonus if we use tablets that are confusing to the elderly or have perpetually low batteries!

Now if you'll excuse me, I have to tee off in 20 minutes

It is called an encounter/patient history form.

There is no difference than handing you a tablet, or the traditional method of handing you a clipboard with a couple of sheets asking you take check off illnesses/you may or may not have.

It being done digitally is ultimately more efficient and saves waste on paper.

In the paper situation you fill out the form, the office worker tosses it in your file.  The doctor looks it over, might ask you some questions about it.

Now it all done on tablets.

And it takes the middleman out of it.  The patient no longer can say"well, that girl at the front desk must have changed it."


I hate ED notes.  Now they're just a bunch of paragraphs generated by physician-clicked fields.  "Exacerbating factors are none, medications taken are none".  They are absolutely useless as far as readability.

I always look for some part of the note that was actually typed.  I want some distillation of the subjective, objective, assessment and plan that come with medical training, not whatever fields some researcher or biller thought important to document in a patient record.

If I can't find any of that, I trust very little of what appears in an ED note.  I'll try to talk to the doc or at least the nurse directly, even at the expense of delaying a case a bit.  Click-field generated notes are useless.
 
5 days ago  

Some Junkie Cosmonaut: Chariset: Why do we have this sudden influx of people with chest pain and allergies to everything except morphine?

Don't be allergic to morphine either.  I'm not, but it does cause me enormous amounts of digestive/elimination issues, thus it's pretty contraindicated unless I'm dying and it's all you have.  Dilaudid on the other hand works fine.  Now, combine that with a pain condition (RSD/CRPS) that sometimes reaches Defcon 1.  No faster way to make an ER doc/nurse suspicious than to have actual knowledge of how painkillers work on you, regardless of the reason you know.  Now, try explaining all that when you're having difficulty not screaming because it hurts so damn much.  It's a lot of damn fun.


You have documented CRPS, hopefully docs will know what's up and why you feel like that.

Ever gotten a block or something along those lines?  I know ED docs don't do them, but if your hospital has an acute pain service, maybe an extremity block is a possibility.
 
5 days ago  

Benjimin_Dover: common sense is an oxymoron: theflatline: How is doing it digitally on a tablet different from this?  It is not. Patient still fills out out.

[printabletemplates.com image 723x1024]

The patient history questionnaire is one thing.  This guy wants the patient to essentially perform and report the physical examination.  A patient who might have a reason to exaggerate their symptoms to be seen sooner, or who might not have the education and training required of the medical scribes who do the job when the doctors don't do it themselves.

His complaint is that he doesn't like doing an essential part of his job and doesn't want to pay a professional to do it for him.  Maybe he should find another line of work.

The way it is done now is the patient is asked questions by somebody when they get to the ER. That person then enters that into the record and the patient begins the wait period to be seen by the doctor.

Now:
Worker~ Where does it hurt?
Patient~ Abdomin
Worker~ How much does it hurt on a scale of 1 to 10?
Patient~ 8.

Proposed:
Tablet/phone~ Where does it hurt?
Patient~ Abdomin.
Tablet/phone ~ How much does it hurt on a scale of 1 to 10?
Patient~ 8.

In the way it works now, the worker isn't changing the answer to what he think it should be so there isn't any value in requiring him for all patients. The only value he brings is for patients who cannot or will not interact with the tablet/phone to enter their answers directly.


Except that depending on the symptom, the worker may end up triaging something based on patient appearance or the symptom or the severity. Handing a tablet to somebody takes away that possibility.

You should read a book called God's Hotel.  It's not really religious, it's about a doc that still got to practice what she called slow medicine, that old-school medicine that went away because it was "inefficient".

She has a fantastic chapter on "The inefficiency of efficiency".  It's goddamn brilliant, and it shows just how in the short term, a tablet might be faster, but in the long term, you're taking away the experience and expertise of somebody who might be slower, but make the system run more efficiently anyway.

Healthcare shouldn't be looked at like a manufacturing plant.  We're not workers just insta)ing the same component on the same model car.  It's way more complex than that, and that complexity requires training.  The moment you try to simplify too much and remove complexity, you run the danger of negating training as well.
 
5 days ago  

RogermcAllen: Front of the line is easy peasy.  Just show up with a sack of potatoes slumped over your shoulder covered by a blanket and say you have a toddler experiencing respiratory distress.  Once you are in the room tell the doctor, "Well my potatoes are fine, but while you are here can you take a quick look at my leg?"

/I showed up to a half full waiting room with a 3 year old who had a tracheal tug and I didn't even need to stop walking at the front desk


Sorry, what's a tracheal tug?
 
4 days ago  
Sounds like something that could be called an EPIC fail.

/Medical people will get it
 
4 days ago  

Hunter4242: I went to the ER the other week for some nasty bleeding and post-shock symptoms. I was there nearly 12 hours before I was seen. I probably could have gone to urgent care, but doctors/hospitals do a piss-poor job of educating patients on where you go for what.


I went to Urgent care for a breathing treatment due to allergies.  They transported me to the ER on suspicion of a heart attack.  Even after I explained that it happens frequently when I exercise.  Spent 8 hours in the ER for them to send me home after...a breathing treatment.

The whole system is just stupid unless you're visibly injured or near death
 
4 days ago  

meanmutton: common sense is an oxymoron: theflatline: How is doing it digitally on a tablet different from this?  It is not. Patient still fills out out.

[printabletemplates.com image 723x1024]

The patient history questionnaire is one thing.  This guy wants the patient to essentially perform and report the physical examination.  A patient who might have a reason to exaggerate their symptoms to be seen sooner, or who might not have the education and training required of the medical scribes who do the job when the doctors don't do it themselves.

His complaint is that he doesn't like doing an essential part of his job and doesn't want to pay a professional to do it for him.  Maybe he should find another line of work.

That's not at all what he's talking about. He's talking about the job of the medical scribe who comes in after the triage nurse sees a patient to determine priority and before the physician sees the patient. The medical scribe simply records the symptoms that the patient states they are experiencing. It usually doesn't happen until the patient gets into a room and the medical scribes have very limited medical knowledge. They aren't RNs, they aren't MDs.

I know what medical scribes are, and I've never seen one simply come in, take notes, and leave before the doctor arrives.  They don't just record the patient's symptoms, they stay through the entire visit and record all of the diagnostic evaluation that the doctor performs, including testing to confirm the patient's reported symptoms as well as evaluation for any relevant conditions that might not be reported.  They might even record the diagnosis and any prescribed treatment, referrals, and/or medications.  If all scribes did was record symptoms, then there really would be no need for them since all they'd be doing is duplicating part of the intake history as recorded by the triage nurse.

Again, all of this record-keeping is an essential part of the health care process.  This doctor has a problem with that.
 
4 days ago  

Benjimin_Dover: The article said that this is to be employed during the waiting phase. That comes before the examination phase. Have you ever been to an ER? ...


Of course.  I've also read the part of the article where he explicitly says his goal is to replace medical scribes:

The cost of implementing and maintaining this type of program would likely vary greatly depending on the size of the department, logistics of EMR integration, etc. However, once it is up and running, the ongoing costs ought to be significantly less than the cost of maintaining a full staff of in-person medical scribes.

He wants to replace the examination phase with a patient self-assessment performed during the waiting phase, not for quality-of-care issues but for cost and laziness issues.
 
4 days ago  

meanmutton: fusillade762: One day while on shift in the emergency department, I looked out into the waiting room at the dozens of people waiting to be seen. Many had been waiting for hours.

In my experience ERs don't work that way. I've taken my mom to the ER many times and she's never spent more than two minutes in the waiting area.

Ahh, yes, the person who has taken his mother to the ER "many times" definitely understands how the ER works better than the emergency room physician who literally spends the entirety of his work day in an ER.


Thus the "In my experience" part. Granted she usually ends up going late at night. That might have something to do with it. And the fact that she has chronic heart problems.
 
4 days ago  

rga184: Benjimin_Dover: common sense is an oxymoron: theflatline: How is doing it digitally on a tablet different from this?  It is not. Patient still fills out out.

[printabletemplates.com image 723x1024]

The patient history questionnaire is one thing.  This guy wants the patient to essentially perform and report the physical examination.  A patient who might have a reason to exaggerate their symptoms to be seen sooner, or who might not have the education and training required of the medical scribes who do the job when the doctors don't do it themselves.

His complaint is that he doesn't like doing an essential part of his job and doesn't want to pay a professional to do it for him.  Maybe he should find another line of work.

The way it is done now is the patient is asked questions by somebody when they get to the ER. That person then enters that into the record and the patient begins the wait period to be seen by the doctor.

Now:
Worker~ Where does it hurt?
Patient~ Abdomin
Worker~ How much does it hurt on a scale of 1 to 10?
Patient~ 8.

Proposed:
Tablet/phone~ Where does it hurt?
Patient~ Abdomin.
Tablet/phone ~ How much does it hurt on a scale of 1 to 10?
Patient~ 8.

In the way it works now, the worker isn't changing the answer to what he think it should be so there isn't any value in requiring him for all patients. The only value he brings is for patients who cannot or will not interact with the tablet/phone to enter their answers directly.

Except that depending on the symptom, the worker may end up triaging something based on patient appearance or the symptom or the severity. Handing a tablet to somebody takes away that possibility.

You should read a book called God's Hotel.  It's not really religious, it's about a doc that still got to practice what she called slow medicine, that old-school medicine that went away because it was "inefficient".

She has a fantastic chapter on "The inefficiency of efficiency".  It's goddamn brilliant, and it shows just how in t ...


I'll check that book out.
 
4 days ago  

rga184: RogermcAllen: Front of the line is easy peasy.  Just show up with a sack of potatoes slumped over your shoulder covered by a blanket and say you have a toddler experiencing respiratory distress.  Once you are in the room tell the doctor, "Well my potatoes are fine, but while you are here can you take a quick look at my leg?"

/I showed up to a half full waiting room with a 3 year old who had a tracheal tug and I didn't even need to stop walking at the front desk

Sorry, what's a tracheal tug?


It is so hard to breath that not only are their ribs sucking in, but their neck actually starts sucking in too.  It looks scary as shiat.
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