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office birthday was marked with a cake, every sad event was marked with a card, and she always dressed up on Halloween. People who have not been my patients for years still tell me how much they appreciated the way she always made each of them feel special and important.
In other words, she was everything you could want in a caregiver or friend. This is also a talent. Many of us have been lucky enough to have a “Stephanie” in the office.
In this issue of OFP, we will feature an article by one of the national experts on the patient-centered medical home or PCMH. Hopefully, it can give us the information we need to be adherent with the requirements, while putting to rest our fears that Big Brother will be managing our patients instead of us or that our office will lose its personal touch.
I moved from my small town to a larger one, and the data points are too many and the patients too transitory for me to expect my MAs to know when Mr. Eaton had his last lipid panel or whether Ms. Levesque is due for her mammogram without looking it up. Outsourcing the bean counting will give me more time for the rest of medicine — the comprehensive exam, the sharing of grandchild pictures or work on the new quilt, and absolutely more time for hands-on osteopathy.
My EHR will only replace the parts of humans that are replaceable. It will keep track of the screening requirements, the last flu shot, the allergies, and the referrals. It will help me stay adherent to PCMH guidelines and give me reminders when I need them. And I really don’t begrudge the computers of the world that part of Stephanie’s skill set. In fact, I embrace it because it makes life easier.
Stephanie died in September, too young and too soon. I don’t care that all she knew about patient labs is gone and I don’t care that she won’t remind me not to use latex with Mrs. Grindle. A computer can do all that for me and for anyone else.
I care that the world has lost her smile. I care that she would text me jokes four years after we stopped working in the same office. I care that she would sit on the floor with me as we soothed a patient who had fainted and that she would hold an old man’s hand while I did the skin biopsy he did not want to admit made him nervous. It never occurred to either of us that she could be replaced by a computer. She was everything it means to be “patient-centered” and everything that makes a medical practice feel like home. She could never be replaced by a database.
My real “patient-centered medical home” lies in me and the wonderful people who help me treat them. When my patients and family remember me, I hope that no one eulogizes me by discussing my encyclopedic memory of screening guidelines. And when I name my EHR “Stephanie,” I hope everyone who sees me type asks me where I got the name for the part of my office that knows absolutely everything that is important.