Hit Me Up

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How do you like to be contacted? How do you contact someone else when you need to speak with them or pass along information that you think they need to have?

We live in an information age, and we have a plethora of choices when it comes to connecting with others. We can write letters. (Remember those?) We can send postcards from the edge. We can still send telegrams. Telegrams! (STOP) We can still fax documents. 

We can use instant messaging, direct messaging, email or texting. 

We can FaceTime or Skype. 

With these methods, we contact each other dozens, hundreds, even thousands of times each month

As a doctor in the mental health field, I have mixed feelings about all these direct messages, texts, emails and IMs. I love my technology, God knows I do, and I am one of us who uses my tech toys and tools hundreds of times each day. I keep up with family and friends, write posts to my blog, look at pictures, check the weather, read books, listen to podcasts and music, and watch videos. 

When it comes to my patients, however, I can see myself holding on to the more traditional forms of communication. Why the schism? 

With tech talk, I can hear (or see) what you say, but now how you say it. Let’s face it, psychiatry is a specialty of nuances. Your body language, tone of voice and even your breathing pattern can tell me a lot about what’s going on with you when you tell me that story or ask me that question. 

Face to face time tends to be equated with caring. Which had you rather hear when you are really ill: “Come on in this afternoon and we’ll see you”, or “I’ll have someone get back with you by phone before the end of the day”?

Rapid fire exchanges tend to lead to rapid fire decisions, not always the best thing. If I am being pressured by a nurse to answer an email she sent me yesterday about a medication change for a patient, I might not research my options as thoroughly as I otherwise might have. The nurse and the patient are focused on the rapidity of my response, not necessarily its content.

Missed, or mixed, messages, might never be seen, or seen too late. The worst case scenario, of course, would be an email or text or other communication about suicidal ideation that gets misfiled, deleted or parked for days without being seen. The patient might be reaching out for all the right reasons but never be heard. The results could obviously be disastrous. 

Privacy concerns are in the news. I mean, really. Who sees what you send? Who is in the loop? Who needs to know? 

It’s a new world with instant access, rapid fire conversations and the exchange of billions of thoughts every day.

What do you think about modern day methods of communication and health care? 

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9 thoughts on “Hit Me Up

  1. For most, if not all, of the UK, email or other internet contact between patient and doctor is not done. I don’t know why the authorities can’t get their heads around this concept. We can make appointments via email (though when I tried it, it didn’t work so I went back to the old way of phone) but the simplicity of email or onscreen consultations hasn’t caught on here. (So when I first started reading your blog ‘telepsychiatry’ was completely alien to me and I had to research it. I still find it an odd concept, even despite your recent post about it.)

    I would LOVE to be able to be in email contact with my doctor and health centre. It would save me time and energy, but as you say – given the choice of that or seeing him in person when one’s ill, I’d opt for the latter. Though not with your option of visiting the doctor – when I’m very ill, I prefer the doctor to come to me, as doctors used to do in the old days. Alas their workload is too great these days for that to happen anymore.

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  2. Greg,

    I have just placed 5 cards in the mail to friends who have either lost a loved one or is recovering from illnesses. I mailed 30 postcards last week to families with children that attended our Vacation Bible School. I send thank you notes or cards all the time. I mail invitations to piano students & their families prior to piano recitals. I mail over 125 Christmas cards every Christmas, and sometimes cards at Thanksgiving & Easter.

    I am old-fashioned. I like the traditional way of communicating.

    Now, that doesn’t mean I don’t enjoy the convenience & speed of high tech communication. After all, I am posting here to you! I used Skype while Jeff was gone. I text throughout the day. I email in the evenings when I have time to catch up.

    BUT because of the impersonal factor in higher tech forms of communication, i prefer the hand-written way.

    I guess I am an old-fashioned girl at heart.

    M

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  3. Greg,

    Did not answer the healthcare question.

    The same goes there. I had prefer seeing the nurse’s eyes rather that the top of her head or her back as she (or he) types in the nurses notes by the bedside. I had rather have the physician’s time rather than relinquishing it to dictation, paperwork, & governmental red tape that was not a factor years ago.

    The patient wants & needs the caregiver in person. They need the face to face contact. They need to see the eyes of the caregiver. It goes both ways. Where you, the physician, can read a lot in a face to face meeting…so can the patient.

    M

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  4. Val

    Interesting differences in how things are done there.

    Yes, I can remember doing my very last house call when I was young and in private practice, I saw a person who had cancer and was very depressed. After the interview I sat at the dining room table and discussed the issues with the spouse. It was a difficult but rewarding visit.

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  5. I think if I worked in a hospital setting with your patient population, I would feel similarly. But I have a solo practice with no administrative staff. I am the psychologist, billing department, housekeeping, scheduler, etc. In fact next week, I’m closing the office down from Tues to Friday to repaint.

    I do a lot of scheduling by email. Since I do primarily psychological testing, I also disseminate my testing handout to folks by email, usually after I’ve chatted with them on the phone. Since I am a cancer patient, I also spend a good deal of time in waiting rooms of healthcare offices that have Wifi. This allows me to respond to people more quickly than waiting until I am some where private and can return a phone call.

    I also see lots of kids with ADHD and since it is genetic, a fair number of their parents also have it, along with the short-term and working memory difficulties that usually come along with it. I sometimes use email to summarize the treatment plans that we’ve developed. And even when parents don’t have these challenges, ADHD is one of those “it’s takes a village” type issues. Parents often find themselves in the position of coordinating the treatment plan components at home, at school, and with a variety of specialists.

    Finally, a particular challenge in my job is when a child’s parents separate or are divorced and are experiencing a high degree of conflict. They often do not want to come in to the office together and even when they do, there can be attempts to argue their side via phone or email. Consequently, I follow the recommended best practices and require that communication out of my office be done via email with all parties cc’d on each communication.

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  6. Elizabeth,

    Sounds like this works perfectly for your patients and for you, given your own workflow and your mandated involvement with your own cancer treatment.

    For me, as long as all parties agree on the medium and how it’s used, if it is secure, if it can be documented and archived for later review then it can potentially work.

    Greg

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  7. Oops, I may have replied to you and then again, I may have accidentally deleted my comment by leaning over my computer while typing and accidentally pressing my touch pad. If I deleted it, just think of the best comment you could possibly imagine and that coincidentally, is what I wrote. 😉

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