How can docs really effect change in our patients’ behavior?

This really is the essential question, it is not about meaningful use, in my humble opinion.

Let me ask you, my patient, how can I motivate you to exercise and diet, and stop smoking and cutting back on the caffeine a bit?  How can I get inside your head to break habit?

If I do not show your chart, with multiple boxes to check and drop down lines to click on to satisfy an outside entity, so that I can receive monetary compensation myself or for my organization, does that really help you?

What if I show you on a large TV screen, your weight, and look at the cyclical sine curve, higher in the winter lower in the summer.  We talk about level of activity and how your winter weight with increased activity should be the same as in the summer.   What if I show you how high your blood pressure was last year when I stopped your amlodipine and started metoprolol, and the 3 visits since then your pressure has gone from  158/98 to consistently below 120/80, are you more likely to stay on your medicine?

When you see your total cholesterol going from 328 to 170, and LDL dropping as drastically, all your liver enzymes are fine, and you have no myalgias, are you more likely to stay on your atorvastatin?

We look at your CT scan together after a pneumonia because a little patch on your chest x-ray did not clear, and you can see the early signs of emphysema, and there is no cancer, will you be more inclined to stop smoking?

Regulators, governmental officials, those who want to reduce societal costs, please, the tools are here and currently being used.

Let us be the doctor, so we can effect change in our patient, and please do not shackle us with fear and threats, that will not work.

The interface between the patient and physician is sacred and the electronic record can either help or hurt.  My experience in the small office, is that the electronic record when displayed, not only helps, but effects change in my patients.

When I use a device like the chromebook that can easily mirror into a large screen TV to show everything just described to effect change, I have the process folks are looking for.

I maintain, if given the right applications in the office with the visual aid to help educate and inform the patient, the physician will have a higher likelihood to impact behavior.  But if the physician keeps all of this information on his desktop or lap top and only talks with out displaying, or worse be too consumed with fulfilling meaningful use criteria,  the likelihood to effect change will be much less.

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