Changing mental health services
1 week ago
The personal blog of Duncan Double
Rather than delight users, as Apple and Google do regularly, the electronic health record is a towering source of physician dissatisfaction
Though child can operate iPhone, physicians with 7-10 years postcollegiate education are brought to their knees by electronic health records
Physicians are not Luddites, technophobes, or dinosaurs about electronic health records
Only one in three physicians say electronic health records have improved job satisfaction
Medicine is an unusually expert-centric and somewhat arrogant field, so IT companies were slow to embrace user-centered design
The drive for greater accountability over recent years has not always been well implemented (eg. see previous post). Care did need to change to be more patient-centred rather than doctor-centred (eg. see previous post). But practice has become too fragmented and dysfunctional. As Hunter concludes:-sacrificed early evenings, studied hard, saw patients, and provided “good” care. In return for these sacrifices doctors got reasonable remuneration; reasonable work-life balance later; autonomy; job security; deference; and respect.
resolving the concerns [of unhappy doctors] remains as big a challenge now as [15 years ago], regardless of the immediate outcome of the present dispute.
Our recommendation that there should be a single local commissioner for the new single budget does raise the question of who this should be. We have not had time to explore that in any detail, although, as we said in our interim report, a sterile debate should be avoided over whether health should take over the commissioning of social care or whether local authorities should commission the NHS. We do note however, that a number of others, including the House of Commons Health Select Committee, have said that over time the new health and wellbeing boards could evolve into a single commissioner for health and social care locally. That idea has its attractions. We recommend that work be undertaken to explore whether the health and wellbeing boards could evolve into the single commissioner for our new settlement.