We can do better
A few weeks ago, I had a really bad sore throat after a simple cold. It went on for about ten days. It was Friday, I was tired of the sore throat and I was afraid that if it won’t go away, I will be in pain all week-end.
I called my primary care physician/provider (PCP) office and begged for a same day appointment. They asked me how soon can I get there. 🙂 “20 minutes”, I said. “We’ll see you in 20 minutes”.
I got there, they did the registration quickly and I was “roomed” (weight, blood pressure measurements, a few questions from the physician assistant – PA). I was going to see the nurse practitioner (NP), not my normal doctor, which was perfectly fine for me.
The NP came in, asked a few questions about my cold, checked my lungs, ears, throat, and did a Strep test. She mentioned giving me Amoxil. She recommended lots of fluids, Tylenol, Advil, Motrin round the clock and Amoxil for ten days even before getting the results of the Strep test and call back if not OK by next week.
I was thrilled to get my antibiotic prescription, did not ask any questions and left. I started taking the Amoxicillin, and 24 hours later I felt better. A week later I was as good as new.
So how can we do better?
Reflecting back at the visit, while working on becoming an e-patient (engaged, empowered, enabled), I realized that from the perspective of me as a unique individual, this appointment was bad in many ways:
– The meaningful use certified EMR did not appropriately flag the NP that I have ulcerative colitis UC (extra precautions were needed because antibiotics could cause flares) and that I should not take NSAID (like Advil).
– The NP completely ignored the fact that I have UC – we should have discussed if I really want to take antibiotics considering that I could get a flare (I am well aware of that and yes, I hurt so bad, I really wanted something). She should not have mentioned Advil – I’d like this to be written really high in my record, right under the drug allergies!
– I did not say anything either. As an engaged patient, I should have raised these issues. I was in a hurry, I knew what I want and I was pressured by the hurry in the office, and felt guilty and grateful about coming in on such a short notice.
What do you think? What should an e-patient do? How do we mindfully communicate and educate?