Redesigning Clinical Workflows to Return Joy to Patient Care
Will Doctors Truly Listen to Their Patients in a Virtual World?

I recently tweeted a link to blog post about Dr. Leslie Saxon and USC’s Virtual Care Clinic. I got a great question in reply from Drew Locher.He wisely asked, “Many doctors don’t truly ‘listen to their patient’ in person now. Why/how will that change if it’s remote?”

Dr_-Leslie-SaxonIn the post, Dr. Saxon states, “There is no replacement for human interaction, but research performed at the VCC location, USC’s Institute of Creative Technologies, has shown that people often disclose more to virtual human agents than to actual human care providers. This makes sense because virtual-human interaction occurs on the user’s own schedule and is devoid of judgment. The truth is that with widespread adoption of the electronic medical record, and the additional compliance burden that the Affordable Care Act places on physicians, most U.S. physicians spend between 40 to 60 percent of their working day documenting in the electronic medical record to fulfill compliance mandates—much of this impinges on time spent with patients and involves multiple, mundane and repetitive tasks.”

There are key points here regarding the physicians listening to their patients.As noted, physicians currently spend 40 – 60 percent of their day documenting in the EHR.This is a waste of human potential both in that it turns doctors into data entry clerks, and it negatively impacts the relationship between the patient and physician.

Fifteen years into the gradual adoption of EHRs, we have only begun to scratch the surface of what is possible.As patients directly interact with the EHR and virtual clinicians, they will enter much of the information that physicians are dutifully keyboarding in now.This will allow the physician to review that information much more quickly, providing more time for your doctor to focus on you, rather than on the keyboard and screen. Most physicians long for the opportunity to regain the caring interpersonal interactions with their patients that have too often been lost with the introduction of the EHR.

The other key point is that the information that patients provide to a virtual provider is often more honest and complete than that provided to another human being.Having more accurate and complete information allows physicians to better focus their discussion with the patient to address their greatest concerns.All physicians have experienced the question that comes from the patient “with the hand on the doorknob”, at the end of the appointment, when the doctor is about to walk out of the exam room, and the patient finally gets up the courage to ask about the thing that concerns him or her the most.

When this happens, we doctors have to make a decision between keeping on schedule for all of our other patients, or stopping to recognize that this IS the reason the patient came in and cannot be ignored.When we stay in the room to dive into this real issue, it is hard not to appear distracted as we are calculating the impact on our other patients, and ultimately on our own families as we will likely be late for dinner or our child’s special event.


If the virtual clinician interaction can elicit these questions up front, so that we can start an appointment focused on the most important thing, the patient-physician interaction will be far more satisfying and valuable for both parties.

While technology has the potential to make our lives better, we must be vigilant about the unintended consequences, such as how the EHR has turned doctors into data entry clerks.By vigilantly pursuing continuous process improvement using PDCA, we can work through those consequences and maximize what we value most – improving health through a caring, honest, and open doctor-patient relationship.

What do you think?

Can technology help doctors to be better listeners?

What do we need to watch out for?

Filed Under: EHR

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