Last year Kelly, the woman to whom I am married, had an emergency appendicitis and appendectomy. She was in the hospital for several days as there were complications. The appendix had ruptured and therefore required immediate and intensive surgery. While the quality of the surgery was excellent and overall care was good (she has made a full recovery) I noticed something surprising while at the hospital.
What sticks with me one year later was that the majority of care providers (nurses and other staff members) spent most of the time they were “attending” to Kelly looking at the monitor they had on their huge electronic chart computers. These computers were wheeled around from patient room to patient room. While the care providers did competently manage all the technical aspects of care, most of the time the focus was on ensuring that everything was documented in the chart. In a five-minute stay in the room, about one minute would be focusing on Kelly: talking with her, checking a vital sign, or making sure the IV was correctly functioning. The other four minutes would be checking the chart and entering data. When I would go outside of Kelly’s room, I would see all of these carts and all of these care providers spending even more time looking at the monitors and entering more information. Let me be clear, the care providers were working, and working hard, but the focus of the work was misplaced.
There is a real problem: patient care has given way to chart care. Perhaps this focus on the chart is about accountability, the fear of being sued, or “evidence-based” medicine. I do not know why it is happening, but patient care suffers when care providers are more focused on entering data into a machine than they are on interacting with a live human being.
Would documentation suffer if care providers spent more time talking with the patient? Would patient outcomes improve if more time was spent talking with the patient? It is time to start rehumanizing medicine.
Michael Winters is a Psychologist in Houston focusing on marriage counseling and therapy. Michael received his PhD from the University of Memphis and has been practicing since 1991.