Finally, a way to prove what everyone suspects already.  A study coming not from a medical journal, but from the much-venerated Consumer Electronics Show in Las Vegas. Patients relate LOTS better to frequent communications involving personal electronics (cell phone) than they do to infrequent communications from a human physician and his/her team of physician extenders (nursing staff, physician’s assistants, technicians, etc) and print information. For one thing, this does not exactly sound like a double-blind placebo-controlled study.  It is clear to me that when electronic communication is used, these are, simply, for frequent contacts. The real problem, I think, is where we went awry and why we need all this to catch up. The doctor patient relationship has been on the skids for years.  Even the most intuitive of people watchers could have guessed that when you have a relationship where interactions are both structured and hurried, not to mention far apart, the relationship follows some kind of entropy – a scientific term for disintegrating or winding down. The “doctor extenders” are of varying quality, as well as varying emotionality and attachment. This means they sometimes help and sometimes don’t. Time and time again I have told patients, “You only have to know the one, or at the most 2 or 3 (usually), diseases you have got to get through life.”  When I send them to libraries, give them book titles, magazine references, whatever, it does not happen. Send it to them on their cell phone!! “Here are four months worth of medicine, one month with three renewals,” I would tell my long-suffering patients.  “No, I am not going to give you a year’s worth. Even though I expect they will be normal, you really have to get those blood tests.”

When they get oppositional, I get crusty — Yes, adorable me. “Look, it is your responsibility if you cannot get in there and get them, not mine.  I want you to do what is safe and good.  I can only tell you.  You really need to do this.  I am not kidding.  I cannot come to your house and remind you or even call you to remind you.”

“I can’t.  I think I am taking care of most of the county.” Or then, there is sometimes the cruelest cut of all. “Of course there will be a psychiatrist here when you come back.  No, it is unlikely to be me.  I do not have any idea who it will be.” Read more on Phoning It In Is Better…