Giving regular feedback to your doctor is very important in the treatment process. This is good for the patient, and for the doctor as well, as doctors learn from their patients !

What makes a good doctor good is the fact that he has good clinical judgment. This is a term which is hard to define, but basically a good doctor is one has seen and treated and learned from lots of patients, each of whom adds to his knowledgebase and clinical wisdom. As the saying goes, "Good judgment comes from experience. Experience comes from bad judgment."

However, the mere passage of time does not provide good judgment . After all, 20 years of being a doctor could simply mean 20 years of doing the wrong thing ! It's important that doctors learn from their experience - and the only way they can do so is by tracking the outcomes of the patients they treat.

Unfortunately, this rarely happens in real life ! Let's take 2 patients whom a family physician treats for abdominal pain. One gets better and moves on with his life. He does not tell the doctor he is better, because who goes to a doctor when they are fine ? The other may get worse and may end up needing an appendectomy. However, he's not likely to go back to the doctor either ( unless he is angry and wants to sue !). This means that both patients who get better and those who don't rarely provide feedback to their doctor in real life.

However, without this feedback, how is the poor doctor going to learn ? He naively assumes all his patients have got better - and he loses track of those who do not improve , because unhappy patients will do their best to find another doctor.

How can doctors practise evidence based medicine ( EBM) without any evidence ? They need feedback from patients, so that can learn whether what they are doing doing is useful or not ?

EMRs can be a great tool in facilitating this kind of patient feedback ! One week after every clinical encounter, the system can automatically send an email to the patient, asking for feedback. This will provide very useful data - for which each doctor can learn about what he did right - and what he messed up.

Many doctors will agree that it can be very frustrating to treat an "interesting patient" - and then never find out how the story ends, because the patient never comes back and is "lost to followup" !

Not only will this data help doctors to learn and improve , it can also be very useful as a clinical practice builder , because patients are touched when their doctor reaches out to them proactively. Patients are happy when they learn that the doctor is interested in finding out how they are doing - and happy patients make for happy doctors !

Authored by : Dr Aniruddha Malpani, MD and reviewed by Dr Anjali Malpani.

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