The Bigger Picture: Are Stories Dead?
How do EMRs change physician-patient interviews?
By Pamela Moore Confession: I once made medical students read George Eliot’s “Middlemarch.” That’s 800–plus pages of 19th century musings on philosophy, art, and medicine. Boy, did they hate me. But the novel was a required part of a course about storytelling and medicine that I was teaching during my prior life in academia. The idea was that the ethics and art of medicine lie within narrative.
After all, what is the physician-patient interview but an opportunity to tell a story? “The story is what it’s all about. When you learn in medical school to give a report, the ones who did really well told a story,” says Jonathan Bertman, a practicing family physician and founder of Amazing Charts, an electronic medical record (EMR) company.
But the fine medical tradition of storytelling seems threatened in the era of EMRs. Electronic medical records are great at capturing standard information, but not so good at structuring patient experience into a narrative.
We’ve been told that EMRs merely change the way information is gathered and organized. But when you think about it, isn’t that the same thing as changing the way medicine is delivered?
Conducting a patient interview while following EMR templates can be like “doing inventory,” Bertman worries. Is that how we really want doctors practicing medicine? “Patients want doctors who listen, care, and grieve with them,” says Bertman. “Objective findings should be objective, but to try and standardize emotions is difficult.” Continued...
