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Opinion: Losing Touch With Patients


Once again, though, I can't have that discussion or properly teach my patients without face to face contact.

In addition, all medicines have side-effects. The higher the dose, or the greater the number of medications, the greater the number of side-effects. In today's rushed office environment, I may only have time to discuss the major, and most common, side-effects. But you may not experience the classic side-effects. You may experience subtle symptoms that are related to the medication. You may have a different opinion about the drug because of the experiences of a spouse or parent. You may have questions or you may not even know what questions to ask. An experienced doctor can elicit questions from you that you may not have known you wanted to ask. Again, this is best done face to face where you and your doctor have the advantage of body language as well.

Another perhaps less important, but practical issue nonetheless, concerns payment of services. In the current clime of healthcare, a doctor is only paid -- or can submit a bill to an insurance company -- if they actually see and interact with the patient. Encouraging phone medicine and or practice via the Internet further increases the amount of unreimbursed services a doctor is expected to provide. This may not immediately concern you, but as a patient, over time, this problem could make it less and less likely that quality will be adequately maintained.

So, keep the technology coming. But for all that this new technology can offer in perhaps a slight increase in the accuracy of blood pressure measurements, I am not yet convinced that it addresses the primary problem of blood pressure management, namely the unique circumstances of each patient. It merely replaces the several already available methods by which you the patient have to self-monitor.

Since most doctors who are treating patients for high blood pressure already have their patients self-monitor, and already adjust the medications based on those measurements and others, I think this new technology offers only a small advantage for treatment -- and a potentially larger disadvantage for the doctor-patient relationship.


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