So the iPhone has finally made a leap in technology that makes every physician all a twitter, in the old sense of the word. The iPhone now runs a gorgeous and practical version of a medical application called Epocrates.
Epocrates embodies what is great about technology. It makes technology let you be a better doctor and be more accessible to your patients in the here and now of an exam room. A doctor using Epocrates can look up any medication, brand or generic, find out adult dosing, pediatric dosing, contraindications, drug interactions, adverse reactions, even standard cost information, and my favorite, what size pills the medication comes in. In my office I can sit face to face with a patient and quickly look up any or all of this information on my PDA. I love it. My patients love it.
iPhone went from not previously compatible with Epocrates, to one major leap better. Now with an iPhone, Epocrates can show you not only what a pill looks like, in typical gorgeous apple graphics, but also can enable you to take a pill in front of you of unknown content and look up what it is. Got a green and white capsule in front of you? You can look it up by shape and color and presto you know your patient is holding a Prozac capsule.
I tend to be a late adopter of new technology, but I used the "iPhone-cannot-run-Epocrates" as a reason to stay way from this lustful object. But now it does run Epocrates. So I am sorely tempted.
But will technology put my patients' privacy at risk?
I am a private practice psychiatrist. I practice out of network of insurance companies. So if you come to see me, you can pay cash and can pretend like it never happened. And some of my patients do. I am my own secretary. I do my own scheduling with my patients directly onto a paper calendar. I keep paper charts that I keep locked in my home file cabinet, so even a theft in my office will not get the thief anyone's charts. I answer all my own phone calls. I do not use email with patients. I do my own word-processing. I password protect all documents twice over that are patient related. You get the idea.
But I struggle with the potential conveniences of technology. To email about scheduling. To have an electronic medical record that would save my sore hands at the end of the day and enable me to print out old records for a patient instead of standing at a copier for an hour. Would I spend more time with patients and family and less time filing and copying?
Doctors who are 5-10 years younger than I am do not have this struggle. In the same profession, in similar out of network practices, they use Google calendar for their practice scheduling. They use electronic medical records for charting. They have all their patient information on their smartphones.
With an iPhone I could keep my work calendar and all my patient information in one place. I could have instant access to a patient's phone number and next appointment information when I check my messages and get one from someone who forgets when they are due in next. I could have their pharmacy phone number programmed in to call in their run out medication and prevent withdrawal symptoms when they call me for the refill but forget to leave the pharmacy's phone number.
But that information would be on a server somewhere in cyberspace.
Does it matter?