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What Choices Are You Offering Your Patients?


In order to truly bring about the progress we need in medicine, it is time we started approaching how we practice medicine in an innovative way.

"Caramel frappuccino with whole milk, whipped cream and an extra shot of espresso."

"Mocha cappuccino with soy milk and a shot of hazelnut."

"Green tea latte, hot, with extra sweetener."

These are three orders I overheard during my latest trip to Starbucks. Wow, that is a lot of choices! It used to be that when you wanted coffee to drink your choice was regular or decaf. Not anymore - Starbucks paved the way for individual choice. Not only can you choose what type of coffee, but you can choose how you want that coffee prepared (hot, iced, frozen), if you want extra flavors (too many to list) and even what type of milk you prefer.

So many choices ... which makes sense since we are all individuals who can have vastly different tastes. Clearly Starbucks, along with iTunes, Netflix, Amazon and other companies has helped move us out of the generic-ey mindset of yesteryear, but why has modern medicine remained in this stagnant, unchanging, and yes, generic arena?

Let me give you some examples: how many of you write the same core group of 10-20 prescriptions all the time? How many of you give the same diet and exercise advice all the time? How many of you use the same diagnosis codes over and over again?

If we were all together in a lecture hall, I am convinced the number of you raising your hands for these questions would be close to 100 percent. In fact, a list of the top ten most frequently prescribed meds include: Paxil, Lexapro, Hydrocodone, Xanax, Effexor, Oxycodone and Lisinopril. Yes, we want to believe that we embrace the individuality of medicine, when in fact, we write for the same meds over and over and over again.

I completely realize that it is difficult to compare prescription writing to coffee choice, but I do so to illustrate a point: Medicine is stuck in the antiquated mindset that prefers the generic, treat-everyone-the-same, shoot-for-reference-range-lab-numbers mindset.

In order to truly bring about the progress we need in medicine, it is time we started approaching how we practice medicine in an innovative way. To further help illustrate this, here is a chart of the “old/ current” visions of medicine compared to the “newer” visions:

I could go on and on. The idea here is that innovation in medicine will occur and we can either choose to embrace it or not.

If we, as physicians, want to truly be in charge of our careers, then it is time we stopped following the lead of the status quo of medicine and sought methods and ways to bring individuality and interaction to our patients.

There are many reasons why modern medicine is stuck, but right now is the perfect time for us to choose whether we want to keep writing the same prescription meds over and over or if we want to start innovating how we go about the practice of medicine.

Yes, we have a unique place in our society - we are the healers and gatekeepers of health and well-being. But in order for us to stay active in these roles, we need to lay down the tools of yesterday and start showing off the tools of tomorrow. Patients are individuals and we need to show them that we understand this concept now more than ever.

For more on Craig Koniver and our other Practice Notes bloggers, click here.

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