Change Is Good, Right?

Jonathan Bock, MD

Academic physician–scientist laryngologist at Otolaryngology Center for Advanced Care, Froedtert Hospital, and professor of otolaryngology at the Medical College of Wisconsin, both in Milwaukee

One of the biggest changes in my practice in the last 10 years has been the increased constant connection that patients now expect from their doctors through MyChart messaging and other virtual and phone contact mechanisms. The sheer number of messages we get daily that need to be addressed requires an entire team of nurses and adds significant time and effort to our daily work, and none of it is really reimbursed. There are some positives to this, as patients have easier access to their doctors and can do follow-up through messaging more easily, but the increased work for the care team is significant and not really considered at all in our pay/reimbursement.

The other real change is the utility of virtual visits and care for patients. Many choose these now for follow-up, wound checks, even initial consultations when they live far away from our academic center. It really facilitates care.

Travis Tate Tollefson, MD, MPH

Director and professor of facial plastic and reconstructive surgery at UC Davis, and co-director of the UC Davis cleft and craniofacial program in Sacramento, Calif.

When considering the biggest changes in my practice, I think of the change in patient care note writing.

I remember well the thick file folders of patient records in the clinic doors with written notes and the speed we could open to our last handwritten message that immediately reminded us of the patient’s story and priorities for care. Maybe similar to the often-described benefits of journal writing with a pen or pencil compared to typing out ideas, I long for the written note and the simplicity of a time when note writing was limited to the critical elements. Prior to our reactive compulsion with efficiency, coding, modifiers, and overall clicking to allow metadata to be tracked, we documented less, yet may have communicated more.

Amber Luong, MD, PhD

Professor of otorhinolaryngology–head and neck surgery and vice chair of academic affairs in the department of otorhinolaryngology–head and neck surgery at McGovern Medical School at UTHealth Houston in Texas

For rhinology, it is the introduction of biologics in the management of chronic rhinosinusitis with nasal polyps. Patients who in the past would get multiple surgeries for their recurrent polyps are now being offered biologics.