Yesterday, I had a phone call from Jay Mercer. He's an Ottawa family physician and leader of the CMA's physician website project. He read my post about our Urology Associates website, and saw my request for ideas on what content we should include.
He had some great suggestions on how other physicians have been using the Mydoctor websites. I'll be testing these out on my practice website.
I'd like to supply information for referring physicians as well as patients. In particular, I'm interested in an online tool that will standardize referrals for common conditions and remind physicians what information and testing will be useful before their patient's visit with me.
Jay also mentioned that there is a contest next month for the most improved website. Seeing as we're starting from zero, we should have a good shot at the prize!
How about helping me out with some of your ideas... Maybe we could split the prize?
Saturday, September 29, 2007
Urology Associates Website II
Wednesday, September 26, 2007
A Tale of Two Consults
I received an interesting consult this week. It read "I think I'll let this man describe his own symptoms to you."
I sometimes get referral letters that carry brevity to the extreme: "BPH" and "ED" come to mind. One referring doc occasionally sends a one letter consult: "P". I don't know if he means "prostate problems" or "difficulty P-ing". I'm sure this brevity is meant to be witty.
But, this is the first time I've received a referral that essentially said "Surprise!"
A referral letter doesn't need to be lengthy, but it should convey a few essentials such as the nature and urgency of the problem, past medical history and pertinent test results. From this, I can decide how quickly I need to see the patient and what other tests I should be arranging for her.
In Saskatchewan, it's not unusual for someone to drive 3 or 4 hours for their consultation with me, so I try to coordinate necessary testing to take place on the same day as the office visit with me so as to spare patients extra trips. If I don't have the necessary information in the referral letter, my patients pay the price (literally).
Adequate information in a referral letter also lets me schedule a suitable appointment duration. Our usual visits are booked for 15 minutes. If I anticipate a more complex problem, I'll book from 30 to 60 minutes.
Consider another patient I saw this week. This man's family physician sent a referral letter indicating a complicated problem that had been going on for over a year. He detailed previous treatments and pertinent test results. From that letter, I could tell that 15 minutes would not be adequate, so I booked 45. At the end of the visit, the man asked me how long I usually spent doing a consultation. I explained that I would usually spend 15 minutes, but that his doctor's thorough referral letter prompted me to arrange a longer visit. He replied that this was the longest time he had spend with a doctor and seemed quite pleased not to be rushed through the visit.
He was satisfied. I was happy not to feel rushed (I hate to keep my next patients waiting). All the necessary test results were available, so I didn't have to track down results and then phone the man with my final opinion. Efficient!
Thank you to my family physician colleagues who routinely send appropriate information in their referrals. The time you spend composing that letter saves time and expense for your patient, and makes their visit with me more productive and satisfying.
Tuesday, September 25, 2007
Survey results - September 17-24
8 surveys went out last week. Only 2 responses. Time for a change in plans...
Click here for survey results.
Urology Associates Website
Our practice website is up. It's extremely bare-bones, but it's a start. We're using the "Websites for Dummies" template supplied by the Canadian Medical Association business management group, Practice Solutions. We thought it best to go with something simple rather than be stuck trying to manage a complicated website on our own.
Now we need content. What would you like to see on a physician's website?
Here are our initial thoughts:Office hours
Location and driving directions with links to a map
Information about common procedures (for us, cystoscopy and vasectomy)
Physicians' names and brief bios
Any suggestions?
Monday, September 24, 2007
Tech notes II
This is for the real gadget freaks!
I've got comment moderation enabled on the blog. Translation: If you leave a comment (please do!) after any of the posts, Blogger emails it to me and I have to OK it being published. I wanted this option so as to delete unwanted spam and inappropriate language (you know who you are, potty-mouths).
Previously, I would get the email on my PDA (Palm Treo 650) while I was out and about. I then had to find Internet access in order to allow the comment to be posted. But today, I had a minor breakthrough!
The Treo 650 has an Internet browser called Blazer. I haven't used it much as it always seemed very slow. I got an email today about a comment under "1-800-How's my doctoring?". Clicking on the "Publish it" link in the email took me to the Blogger log-in page where I can access this blog and authorize the comment. Sweet!
I've already experimented with "mobile" posting directly from my PDA but this "discovery" makes the whole works mobile. Not impressed? Well, you were warned - this was for gadget freaks only!
Thursday, September 20, 2007
Welcome HQC-ers!
I shamelessly plugged Plain Brown Wrapper in my Advanced Access blog. If you surfed over from Health Quality Council, welcome! I hope you'll poke around a bit. I started up PBW to support my patient satisfaction survey project (see below), but I found that blogging is mildly addictive.
I'll still be reporting our progress with Advanced Access on the HQC blog, but I wanted to explore some other areas and try other schemes. I'm grateful for all of you who are loyal readers about Advanced Access, and I'd like to tap your experience and expertise in this blog. Please leave comments and suggestions after any posts that catch your interest.
Wednesday, September 19, 2007
RateMDs: Saint or Satan?
Physicians who know about RateMDs are rarely neutral about it. Physicians who don't know about RateMDs... well, watch out, docs!
RateMDs is an online information exchange where anyone can anonymously post comments about a (North American) physician. There are similar sites for rating lawyers, high school teachers, university profs, etc.
RateMDs sparked my online patient satisfaction survey. Here's why:
Physician rating sites have existed as long as there have been physicians. These sites used to be called coffee row, the backyard fence, and your cousin's friend who knows someone who knows someone. The information was there, but was informal and relatively inaccessible unless you were "connected". Now, the Internet makes everyone connected, and they're sharing information.
Browse through RateMDs (c'mon, you know you want to), and you'll see why some physicians are upset about being rated. There are some pretty frank comments. Some may be accurate and deserved. Others may be vindictive and slanderous. We have no way of knowing. Perhaps looking at the pattern of comments gives a reliable picture of each physician's demeanor. I'd like to think so, but comments and ratings for individual physicians vary quite widely in some cases. One person with a vendetta could leave multiple posts slagging the doc. A physician could salt his own page with glowing praise.
There are weaknesses with the RateMDs model, but the idea is here to stay. I think we should embrace the idea, improve the model and turn it to the benefit of our patients. After all, what physician doesn't want honest, frank feedback on his or her performance?
Ha, ha! Of course, I'm being facetious! I'm a lot more comfortable not hearing about my weaknesses and bad habits, and I'm sure many other physicians feel the same way. If I know my performance is substandard, the logical and professional response is: try to improve. And that means... Change! Before physicians decide to ask for feedback from our patients, we need to commit to making the changes that the responses suggest.
I want to solicit patients' opinions about my performance, but I also want to draw on their experience and insight to make constructive suggestions on how I can improve. To that end, I made my own post (April 17, 2007) on RateMDs encouraging people to comment on how I can improve my medical practice.
As you see on my RateMDs page, there haven't been many responses to that request. As such, I decided to start my own personal rating service. I'm requesting patients to take a web-based survey about their experience in my office. In the spirit of openness, I'll post a link to the survey responses on my blog.
How can you be sure that I haven't polished up or even completely faked the survey results? Right now, you can't. But, I welcome any suggestions on how I could set this up so I can't be accused of fabricating results. (At the moment, I feel I need to review the responses before posting them just in case a patient has included private personal or medical information that should not become public knowledge.)
Any suggestions?
