Every once in a while,

by francine Hardaway on December 14, 2004

Every once in a while, I am bowled over by the changes made in our lives by the digital revolution. Although health care is universally said to be behind the power curve in its use of technology (I�ve railed about the lack of patient accessible electronic medical records for years), the way in which it has changed recently is truly amazing. And it�s only going to get better.

Last week I went to get an X-Ray of my lumbar spine, something everyone of a certain age can look forward to. Now, I�m not without knowledge about radiology (or diagnostic imaging, as it is now called), being the widow of a radiologist. But just a scant seven years ago, my late husband Gerry took real films in his office, developed them with chemicals, waited for them to dry, read them as quickly as he could, and got a diagnosis faxed to the referring physician. Everything was done by fax.

Kodak was his major supplier for film. Siemens made the equipment.

Gerry also read films for other doctors, who took them in their own offices on their own equipment (some good, some poor) and sent them to him. Those he read in his spare time, often at the beginning or end of the day. Piles of them. God only knows how long those patients waited to get their results.

After thirty-five years in practice, Gerry had a full storage room containing only films, each of which belonged to a patient. A patient who wanted to take his X-rays for a second opinion had to pick up his films and physically transport them to the other doctor�s office, and then physically bring them back (if that was their desire).

Flash forward to 2004, and Francine at the The Orthopedic Center of Arizona in Phoenix, a practice that services the Suns and the Diamondbacks in a fancy facility near the Biltmore.

Although it�s still Siemens, all the equipment is now digital, No film. (Poor Kodak.) I lay on the table, the technician takes the pictures, and they are fed into a computer. They will be emailed to the radiologist who will read them. He�s not in this office, although fortunately he is in this country. If this were an emergency over night, he might easily be in India.

I get up off the table. The tech tells me it will take two or three days for my doctor to get the results. The radiologist is probably reading all the films at the end of the day, as Gerry did. But if I am willing to wait, the technician tells me, she can give me copies of my films. Ten minutes later, I walk out with six large glossy prints of my left hip and lumbar spine.

Unlike the past, in the intervening time I can take my pictures home, search the Internet for sites such as e-spine.com, and see informational pictures of conditions similar to mine. I can learn how to �read� my own X-rays and make my own preliminary diagnosis. I already know the name of my condition, spondylolisthesis; I am trying to see if it has gotten worse. In ten minutes, I have an answer. It has not. I compare my print to the one on the computer � still Grade 1 or 2.

Yesterday I went to see my new family doctor, a man I have met only twice (he is on my new health plan). He has no clue about my past; he looked at the report and had nothing to compare it to. He said, �your back is a wreck.�

I said, �it hasn�t changed in six years.� I had had all my medical records from the old doctor copied and mailed to me. I brought him the radiologist�s report from my last X-ray, six years ago, that said I had grade 2 spondylolisthesis. He looked at it and refined his earlier suggestion that I have my back fused immediately.

This time he told me I needed a hip replacement. �How much pain are you in?� he asked. �Almost none,� I replied. �Oh well, then,� he said. �They won�t do it.�

This was almost a comedy, trying to educate this nice man. But in six more years, I won�t have to do this; he will be able to go on line and see my medical history no matter who my former physician was � as long as I give him permission to do so.

As for me, I feel empowered. Although I am technically still the �patient,� and although I would never presume to recommend treatment to myself or anyone else, I now have information.

I know why people who go to doctors used to be called �patients;� it�s because of all the waiting they had to do in order to get information. Once you don�t have to wait, you should be called something else. The client? The customer? The partner? The collaborator? Your suggestion here____________.

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