My favorite Italian restaurant in our town is a little place called Nick's. Like most good eateries, this one is always packed with a wide swath of folks from our community. And among the families sharing platters of pasta is usually a patient or two.
I'm always grateful for this kind of informal communication with patients. I get to ask after their nose or thumb or hip… and usually inquire about that trip they were about to take when I saw them, or their son that played quietly in the corner of the exam room. I never thought much about these interactions until my daughter commented on it.
"Dad," she said, "How can you possibly remember all of those details when you see so many patients?" I shrugged. Being familiar with the details of my patients' lives is as much a part of my job as being able to do a flap effectively.
I take my ability to remember these things for granted, for the most part. I expect myself to remember a patient's name, condition, family, job struggles, and point of view. I expect myself to recall details of decades-old cases in my communication with patients. And I expect myself to remember an interesting case to share with young students.
Or, at least, I thought I did until I heard this TED Radio Hour on Memory. One quote from Scott Fraser, a forensic psychologist and expert on memory, stood out to me in particular:
"We all have to be very careful. All our memories are reconstructed memories. They are the product of what we originally experienced and everything that's happened afterwards. They're dynamic. They're malleable. They're volatile, and as a result, we all need to remember to be cautious, that the accuracy of our memories is not measured in how vivid they are nor how certain you are that they're correct."
There are reams of research (not all of it useful) on the best methods for communication with patients, like this piece on whether patients actually prefer a patient-centered style. But no matter what your approach, it's crucial to be able to remember the details of what happened as you communicate. I have not found EMRs to be useful aids, as they're not searchable and the information is organized in such a way that I can't seem to pull out the story of the patient.
I do think it's likely that my memory for patients is trained, and thus better than average in this context, but I also know that it can be immensely valuable to have tools that help me remember a patient's full story accurately. Although I hadn't realized it, I have been using ClickCare as a tool, not just for collaboration, but for remembering full cases. That better "remembering" has also led to better communication with patients (as well as with other colleagues and with students.)
So while I can usually remember my patients when I see them in Nick's, I'm incredibly grateful to have ClickCare on my iPhone to help me out when I need to remember a nuance about a case -- wherever I happen to be when I need that information.