What does your exam room need most?

Chances are an Improvement Will Work as Well as a Re-invention

If you’ve followed previous blogs it won’t come as a surprise that I put a lot of emphasis on the exam room not only as a key element in an individual practice, but also as a critical step in strengthening primary care medicine itself. As the path to healthcare reform becomes increasingly difficult to clearly follow, it’s a safe bet that I’ll focus on the exam room even more as one of the aspects of the medical world over which we can actually exert control.

Of course, whenever we make changes in any part of the way we have practiced in the past there’s always going to be someone who tells us, “Don’t re-invent the wheel.” If you’ve been given that familiar advice lately, roll this over in your mind:

The research and engineering team that helped develop steel belted radial tires certainly didn’t re-invent the wheel. They didn’t even re-invent the tires that go on the wheel. But they certainly improved them. In the process countless lives were saved over the years from blowout-related accidents. And a lot of people never had to endure the stress of getting a flat tire on a dark and lonely highway.

There’s a pretty direct analogy with the exam room. What we’ve been doing has kept things moving along, but “road conditions” are getting more difficult. This is due to the increase in individuals with health insurance, the expanding population of older adults with multiple health issues and the increased demands of documentation. Let’s face it, the EMR has not been the panacea we hoped for with regard to improving either patient care or workplace conditions. All of these factors have melded into an increasingly difficult scenario.

There’s also that inconvenient shortage of PCPs that we read so much about. It probably stems from a combination of burnout and earlier than expected retirement as well as a growing lack of enthusiasm for Primary Care, a field that’s high on work load and comparatively shorter on reimbursement.

That’s why I keep talking about the exam room and the benefits of a coordinated team approach to care based on deep protocols, a physician willing to make changes and a well-trained and empowered staff that serves as a data gathering and information resource. A staff specifically trained to function inside the exam room to let you focus on patients, not computers. It’s not only a place to start, it’s a place where we can truly make a difference in a relatively short amount of time – especially when compared to the wholesale reconstruction of a broken healthcare system.

Clinicians tend to be intelligent and highly capable people. Most of us, however, are not inventors. But we can all be improvers. The good news is that you can be a highly successful physician on both a professional and personal level without re-inventing the wheel … as long as you keep making it better.


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