I’ve just had a consultation for blocked ears, with a GP at a busy Adelaide clinic. People have told me I don’t listen, but this was definitely a hearing problem. GP took a swab, cleaned me out, gave me a computer-printed prescription for drops and antibiotics, handed me a tiny hand-scrawled chit and sent me on my way suggesting I ring back on tuesday afternoon for the lab results – ostensibly in case the prescription wasn’t appropriate. That all seemed basically OK and efficient. I had to ask what the chit was for. He said “just hand it to reception”. I did just that. Paid my $64 via EFTPOS and received the tiny EFTPOS receipt.
I said to the receptionist, “Don’t I get a proper receipt?”. She told me I could have a copy of the paperwork they send to Medicare with the claim for my $30something reimbursement. I asked to see it. All it had to describe my problem was “Consultation B” or something similar. I told the receptionist that that was useless to me. It seems that this large GP practice had no mechanism for furnishing me with any record whatsoever of the diagnosis and treatment I had just received. Apparently this is par for the course with GP and specialist consultations.
Now just about any other service that I might purchase in the community involves some form of record – usually a docket summarising the services provided. Buying a coffee, for example. For something larger, I might take a business card with contact details – phone, web address, email. Par for the course.
When I last booked my car for a service as a result of being caught in a Sydney flood, I was sent a text SMS reminder to my mobile, I was emailed the confirmation, I was encouraged to discuss the problem when I dropped the car off, and was able to place a cap on what I was prepared to spend. I received a detailed, itemised report of the problem, the work undertaken, and a price breakdown of parts and labour. It cost about $140 and they had clearly spent more than one hour working on removing the water and drying the car thoroughly. I also received a followup email a few days later thanking me for my patronage and checking that everything was still OK with the car. My dental practice is similar in their customer service and record keeping.
But not in GP or medical specialist land. Why is it that we expect, and in most cases accept, such completely different standards in customer service and record keeping? Is it just the results of supply and demand? Is it just the long-entrenched, paternalistic attitude of so many clinicians? Is it a clinical culture of protecting patient information that clinicians see as their property? Is it the result of the funding model used in Australia? Is it the over-represented and outspoken voice of privacy zealots?
Whatever the reason, surely the injection of a little IT into the process could turn things around. I’d love to be emailed a summary of that visit. I’d like to be emailed a copy of my lab results on tuesday. It wouldn’t take much. Just a little awareness and a touch of willingness. Is that too much to ask of the medical world?