Thursday November 27, 2008
'Ask Dr. Brian' Show: Answer #1
On December 15, 2008, White Coat, Black Art is giving the show over to you. We're answering the questions you have about how the health care system works. It's our way of saying thanks for the support you've given the show during our three seasons. We've been deluged with questions -- enough to fill a season's worth of shows! From now until the 'Ask Dr. Brian' show airs, we'd like to answer some of your questions on our blog.
Janik G.Tremblay of St-Basile-le-Grand, Quebec wrote in to say he had a gastrointestinal problem for which he saw more than one specialist without success, only to find much later the one doctor who was able to diagnose an allergy and to recommend effective treatement. He asks:
Why don't specialists talk to each other? Why don't they know what research has been done in another specialty that has ramifications in their own specialty? If this is too much information to manage, as I imagine it is, why aren't computer systems involved in this? PLEASE TALK TO EACH OTHER or get computers to help you. Patients are suffering because of this lack of communication.
Janik, you raise some practical and some philosophical questions. First, the practical stuff. If specialists are involved in your care, they should be communicating with each other and with your family doctor. In fact, they are paid to do so in that consultants' fees under provincial medicare include writing letters back to the referring physician.
On a more philosophical plane, you are correct that physicians who specialize in different aspects of medicine do not communicate much with each other. Along the same lines, specialists tend to focus their reading and continuing education in their area of specialty. With medical knowledge doubling every 5 years, it's a lot easier to stay on top of your field if you limit yourself to one specialty. Frankly, that's one of the reasons why a lot of MDs choose to specialize.
Can computers help keep everyone in contact with each other and with the latest medical knowledge? Absolutely. I am constantly searching the Internet for answers to my medical questions. In addition, computers are capable of linking family doctors with consultants, just as they can link your file in the doctor's office with your chart in the hospital. Trouble is, there are no universally accepted software packages. MDs who are early adopters have been using electronic medical records for years, while the more conservative among us sitll have paper charts.
You may have been hearing about efforts to create a universal electronic medical record or EMR that contains your medical file, is portable, and can be accessed in an emergency by anyone who looks after you. The devil is in the details. On the one hand, you want easy access in an emergency; on the other, you want your records to be secure. I believe that EMRs are inevitable. But getting everyone to agree on a standard is like herding cats. I hope it will be the standard before I retire, but I have my doubts.
Janik, we'll be happy to send you a White Coat, Black Art bone as our way of thanks for sending in your questions.
As always, we love hearing your comments and questions. Write to us on our blog or email us at firstname.lastname@example.org. And tune in Monday, December 15 at 11:30 am (noon NT) and Saturday, December 20 at 4:30 pm (5 pm NT) for more answers.
Previous Comments (3)
Do physicians ask their patient's permission to put the patients medical information on electronic records? Will that be done up front before sharing on universal electronic
Are consumers able to opt out of electronic collection of their medical information.
One province has medical records collected by a U.S. entity. Another has had many hard drives with medical information found in computer auctions, laptops stolen when being taken home or elsewhere.
The internet is insecure.
Please don't tell us about passwords and altruistic personnel who've taken vows of secrecy. That is being violated daily in the provinces where electronic sharing has already begun. One provinces regs, if read carefully, shake out to say anyone can have access, if they feel they have a right.
Do you think casual part-time employees in, say, your podiatrist's office should have access to your urologist's chart on you? They do, in universal electronic medical record sharing. And they don't have to tell you they do.riv, December 1, 2008 11:23 AM
Thanks to the CBC for broadcasting this very valuable program by Dr. Goldman.Maxine, December 21, 2008 9:12 AM
I want to know about the following
1.What means about skin disease ?
2.How many types of the diseases ?
3.How can I cured when I'm living in salt water.SHADRAKA RICHARD MSIANI, March 10, 2009 4:38 AM