Bryan Vartabedian, M.D., FAAP has been blogging about physicians and healthcare since 2006. We recently caught up with him to talk about the management of patient information, care collaboration, the role of social media in healthcare, and the reasons for his optimism about the future of healthcare.
You have said there has never been a better time to be a physician. What are the main changes happening in healthcare today, and why are you optimistic?
This is one of the most exciting periods in the history of medicine. The physician is being completely redefined. Whenever an industry is disrupted, people are hesitant at first, so some of the pessimism you hear reflects that. Some of the forces redefining the physician include technology, third-party control, and health 2.0.
We are moving from a period of intuitive medicine toward one of precision medicine. Increasingly, diagnoses are based on cause, not just symptoms, which is a shift Clay Christensen describes in his book The Innovator’s Prescription. As we move into the age of precision medicine, physicians will become purveyors of information. Physicians increasingly will take all the newly available information, distill it, and equip patients to make difficult decisions. In coming generations, we will see heightened ethical debates around how much patients want to know, how much they need to know, and the types of tests they really need. With the ability to sequence an individual’s genome quickly and inexpensively, we will face tough questions like, “Do I really want to know if I’m going to have Alzheimer’s?” Physicians will help guide the process.
For centuries, physicians had the lion’s share of health information. Today, patients have greater accessibility to information and can do significantly more on their own. Now, patients also have the ability to share this information with other patients and solicit input from other people in addition to their physician. The advantage is that today’s patients are far more empowered–and an empowered patient is a much better patient.
Increasingly, care is centralized and administrated through managed care, driven by evidence-based guidelines and the collection of a lot of data. As data evolves and we collect more complete information in electronic health records (EHRs), the role of the physician will change. We will have more information to consider, and much of what we analyzed on our own will now be overlaid with evidence-based initiatives and protocols.
It’s hard to argue that advances in technology can replace much of what physicians do with our eyes and with our hands, but these advances in technology and information access are remarkable and make our job easier, though very different. I see the glass as half-full.
Do you believe care collaboration can improve clinical outcomes?
Absolutely. Care is fragmented between medical practices and institutions. There is repetitive work that could be avoided if there were more collaboration between offices and institutions.
How important would the accessibility of clinical information from third-party payers in one portal be for you?
Very important. Today, we find ourselves jumping from platform to platform to get what we need, moving between EHRs to other sources of patient information and then tying it all together with other tools for a full patient picture. It’s important that different technologies are seamless and interoperable so they help to improve, rather than disrupt, physicians’ workflows. This clinical information needs to be bidirectional between physician practices and third-party payers to best serve the patient.
You often talk about the evolution from analog to digital physicians. Can you tell us more about that and describe the benefits of a world with more digital physicians?
The primary difference between a digital and an analog physician is most visible in their workflow. Both types of physicians do the same things–see patients, document patient information, and make treatment recommendations. Digital physicians rarely use a pen; they have a digital workflow. There’s also a difference in how we consume our information. A digital physician reads medical information in a digital format. Partly, this is generational. Some physicians really want the feeling of paper in their hands. Today’s medical students go to school with an iPad. We’ll all be digital when our workflow becomes digital. Early digital physicians are next-generation physicians who understand the important role of empowered patients.
You’ve been very involved online for some time now. What do you believe is the role of the physician in the digital age?
My experience with blogging and social media is different from that of most physicians. When I wrote “Colic Solved: The Essential Guide to Infant Reflux and the Care of Your Crying, Difficult-to- Soothe Baby” in 2006, I began blogging for the sole purpose of promoting the book. Eventually I recognized the power of a personal publishing platform and the site continued strong for three years. I began exploring Twitter and Facebook in 2008. In 2009, I witnessed lots of physicians beginning to use social media. I launched 33 charts as a site to discuss the issues facing doctors at the intersection of social media.
I believe that physicians should be participating in online dialogue. In fact, as physicians, we have an obligation to help create the content that our patients read. Even if a physician chooses not to create content, they can pass on good information from their colleagues on sites like Twitter. There are many ways that physicians can participate in a meaningful way on social channels.
Thank you again, Dr. Vartabedian. Our discussion was a pleasure. What do you think about the changes physicians are facing? Are you equally as optimistic? Why or why not? Let us know in the comments below, on Twitter, Facebook, and LinkedIn.
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