Entry No.41c

IT Writers Awards

The AMA has suggested that doctors be allowed to charge a fee of $15 for standard c-mails and phone calls from patients. They say that this form of communication is becoming more common and takes a sizeable part of their time for no remuneration.

There's nothing new about GP's saying they have lots of tasks they don't get paid for, like writing referrals to specialists or forwarding case notes to other GPs, What is changing is the technology that can assist them in their day-to-day jobs (and perhaps in some cases, hinder them).

It makes sense to pay doctors for the time they spend on e-mail consultations because in many cases the alternative would be a more expensive personal visit (It probably makes more sense to pay people on a retainer basis with their GP so it's in the doctor's interest to keep the patient well, but that's another story.) If a patient merely needs to ask if he/she can safely start taking a supplement from a health-store while already on medications for a range of ailments, that sort of question is ideally suited to answering off-line via e-mail. Of course, it could also be answered by the patient logging on to an expert system on the Internet, and entering their existing medications and so on.

But this presents a couple of problems. Would all patients be able to reliably enter what they're taking, especially the dosage? Would they know why they were taking them, if asked? To overcome this, all relevant patient records could be kept in a central database, so when you log on to the knowledgebase it already knows what you're taking and why. That's assuming you're doing the right thing and taking what the doctor says, but experience shows that people do amazingly stupid things like swapping medicines over the back fence or hoarding them while telling the doctor they're taking them. So perhaps the next step would be a routine blood test every few weeks to ensure that you're taking your medicine. It all starts to get a little big-brother-ish.

However, there is one use of technology that could save a fortune in medical costs. Time and time again it's been demonstrated that people will tell a machine things they wouldn't tell a human doctor, even if he/she remembered to ask all the questions.

It could even be a cumulative thing-every time you visit the doctor you spend 15 minutes in front of a terminal, answering questions, which in turn lead to more specific questions. "But wait" you say. "Couldn't that sort of thing be done in the privacy of your own home or at work on the Internet?" And what comes next-data collecting terminals on the back of the toilet door?

It all presents an interesting question of data privacy. Or is all this data kept on your personal smart card and nowhere else? Now please answer yes or no: do you feel any pain in your knees when climbing stairs?

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