J. Tod Fetherling

CEO / Data Geek

The Informed Patient

Don’t confuse the value of Google with your Medical Degree.

Google can search through every medical article ever written on migraines in seconds. Then I can add my symptoms to narrow down the effects of the disease and discuss those symptoms with others who are experiencing the same issues.

Yes, you do have the Physician Desk Reference (PDR), but how much time did you really spend on migraines in medical school? If you were a Family Medicine Physician... Maybe a day or two on headaches?

We are at a point in medicine where we need to leverage technology and physicians to create solutions for patients. It’s not an either or answer, but a 1+1+1 = 5 equation.

If you see this sign in a physician’s office, run. Find a doc who wants you to be educated and can spend time talking about your disease and your concerns.

As patients, how many of us would pay another $40 for 15 minutes of time just talking to our doctors about our lives and how this may affect your diagnosis?

“Do you have anything you need to discuss in more detail?” I can’t believe physicians (and more importantly the physician’s office staff) don’t ask before appointments. Like business consultants, Physicians bill office appoints in increments of time. If you need more time, ask. The best value point is 40 Minutes or the 99205. You get 15 more minutes for ~$40.

New/Established Patients Code: Time (approximate Cost)

  • 99201/99211: 10/5 Minutes (~$20)
  • 99202/99212: 20/10 Minutes (~$50)
  • 99203/99213: 30/15 Minutes (~$80)
  • 99204/99214: 45/25 Minutes (~$110)
  • 99205/99215: 60/40 Minutes (~$150)

As consumers, we haven’t leveraged the revenue cycle mentality of the healthcare system to get better care.

In an age of technology, the physician’s ego has been battered and bruised. Where once a patient went and wholeheartedly trusted the physician’s advice and followed that advice,  we now have the informed patient who, given some time and focus, can be very informed about a particular disease.

The real art of medicine occurs when the patient, the physician, and the technology are one.

Facebook is full of stories related to people who found the right answer faster than the medical community (physician, lab, imaging, tests). It happens every day. Most of the time when I go to the physician’s office, I know my symptoms and a good idea of what's causing my suffering. They take blood and confirm my initial diagnosis. There are many other documented cases where the patient had no idea they had cancer growing slowly in their body.

So in an age of technology, isn’t it time we merged the best minds of the physicians and the best mind of the circuit board? Is this the time for Telemedicine to close the gap so the patient can have a meaningful conversation with a physician who will listen to their needs?

Physicians are also growing discontent as they try to keep up with all the literature in their specialty areas. “Medicine has a TL;DR problem (Too Long; Didn’t Read),” said Nate Gross, MD, co-founder of Doximity. “It would take 20 hours of reading each day for the average physician to comb through everything published in their specialty.”*

There are several tech companies, some with local ties to Nashville, who are trying to close the gap between consumers and physicians:

Physician Office Coding

An Example of what your Explanation of Benefits from an office visit might look like on your bill.

Codeset: CPT

Code: 99201

Description: Office or another outpatient visit for the evaluation and management of a new patient, which requires these 3 key components:

  • A problem focused history
  • A problem focused examination
  • Straightforward medical decision making

Counseling and/or coordination of care with other physicians, other qualified health care professionals, or agencies are provided consistent with the nature of the problem(s) and the patient’s and/or family’s needs. Usually, the presenting problem(s) are self-limited or minor. Typically, 10 minutes are spent face-to-face with the patient and/or family.**

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