Plan Aims to Lift Restrictions on Doctor-Patient Discussions

Marcia Frellick

June 17, 2013

CHICAGO — Two proposals up for debate before American Medical Association (AMA) delegates seek to remove barriers to doctor–patient conversations in the exam room.

One is a resolution proposed by the American College of Physicians Wisconsin Delegation asking the AMA to support an end to government interference in what doctors can discuss with patients.

In Florida, for instance, the Firearm Owners' Privacy Act, enacted in 2011, forbids doctors from asking patients whether there's a gun in the house; the penalty for contravening the Act is a fine or loss of license.

Barbara Hummel, MD, an alternate delegate from Wisconsin, told Medscape Medical News that allowing "the government to start telling physicians what they can discuss with patients — well, that's crazy."

"We're not against guns; that's not the issue. We want to be able to provide some safety. We want to be able to talk to patients about whether they have guns in the house," she added.

Other legislation in Pennsylvania bars doctors from discussing exposure to certain chemicals because of proprietary information. Physicians can access information about the chemicals used in fracking or the extraction of oil and natural gas, for example, but they can't discuss those chemicals with patients.

The proposal will send a message to government that they have no right to interfere, Dr. Hummel explained. "We're asking the AMA to get rid of any of these laws that limit what patients and physicians can discuss in the privacy of the exam room."

Another proposal to be presented here at the AMA 2013 Annual Meeting addresses the potential for interruptions in face-to-face conversations with patients when a physician is entering information into a computer.

Electronic Health Records, Lower Patient Satisfaction

Bringing computers and tablets into the room introduces a screen where there used to be only eye contact between doctors and patients. This can divert physician attention and lower patient satisfaction.

Still, electronic health records in the exam room make real-time access to health information at the point of care possible and can allow for more time to explain diagnoses and diseases.

Studies have shown that health information technology can improve patient adherence to preventive care recommendations and reduce medication errors and cost.

Last year, the House of Delegates asked the Board of Trustees to look into the effect of technology on the physician–patient relationship and on the patient experience.

The Board found that it wasn't the equipment that negatively affected a patient, but the physician's lack of skill or negative perception of the technology. In fact, some patients report they are getting better care if a physician uses computers.

Tips for Improving Human Interaction With Technology

The Board is recommending that the AMA make physicians more aware of resources to help them use computers and electronic health records effectively during patient interactions. They are calling for new publications and satisfaction surveys to evaluate patient perceptions of physician performance.

Kaiser Permanente and the American Academy of Family Practitioners have published tips to improve human interactions with the use of technology:

  • Value the computer as a tool

  • Explain what you are doing

  • Maintain eye contact

  • Let the patient look on and verify information as it is entered

  • Start with patient concerns

  • Separate routine data from patient data

  • When logging off, tell the patient you are doing so to safeguard information

For more information, visit Kaiser Permanente Health Connect and the American Academy of Family Practitioners Web site.

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