(May 2018) Mental health wellness is a top priority for our care providers and
the communities we serve, and there is an increased recognition that we
must actively address this issue to maintain and improve health – our
own and those who depend on us.
Earlier this year, our School’s
Department of Family Medicine was featured in an article in the New
England Journal of Medicine as an example of improving the quality of
care for patients while also reducing the level of stress on providers.
department established a team-based model called ambulatory process
excellence, or APEX. Under this system, medical assistants gather data,
reconcile medications, set the agenda for patient visits, and identify
opportunities to increase preventive care.
The medical assistants
report to the physician or nurse practitioner and then remain in the
room to document the visit with the patient. After the clinician leaves,
the medical assistant remains to provide follow-up education.
Lyon, DO, associate professor of family medicine and medical director
of the A.F. Williams Family Medicine clinic, described the result: “The
chaos in exam rooms before APEX was akin to texting while driving. The
greatest advantage now is that the computer no longer stands between me
and my patients. This allows for deeper thinking and connection.”
provider-patient experience is personal, face-to-face. Eyes are not
staring at a computer screen. Ears are used to truly listen.
dilemma of our hyper-connected era is that technology can make us better
at what we do—more information is available to us faster than ever—but
it can also interfere with the personal connection that any caring
profession must forge.
As a society, we must come to grips with this concern.
spring, the Helen and Arthur E. Johnson Depression Center of the School
of Medicine hosted a lecture by Jean M. Twenge, PhD, professor of
psychology at San Diego State University, on the impact of smartphones
and social media on mental health and suicide risk.
research focuses on how the ubiquity of smartphones is reflected in the
lives of young people. Her book, “iGen,” documents a shift in behavior
among the current generation of teens compared with previous ones that
she attributes in part to an overreliance on socializing through
screens rather than in personal contact.
“But the twin rise of
the smartphone and social media has caused an earthquake of a magnitude
we’ve not seen in a very long time, if ever,” Twenge wrote in an excerpt
of her book that was published in The Atlantic last fall. “There is
compelling evidence that the devices we’ve placed in young people’s
hands are having profound effects on their lives—and making them
She sees a generation with many connections
but few deep bonds. Technology itself isn’t bad, but it shouldn’t be
used to isolate ourselves from one another, she said.
requires care and attention and we must not let the tools we use get in
the way of a better understanding of our students, peers, and patients.
We also need to recognize that sharing some tasks can equal improvements
As Lyon explained, “Providers have to be willing to give
up a little control to get the support they need so that they can build
better connections with patients without technology interfering.”
it required hiring and training medical assistants, it showed that
working together improves the quality of care. Referral rates for
mammography and colonoscopy screening improved. Providers reported a
sharp decrease in burnout. Appointments for an additional three patients
per provider per day could be scheduled.
Our School of Medicine team is showing us a potential way forward.
With warm regards,
John J. Reilly, Jr., MD
Richard D. Krugman Endowed Chair
Dean, School of Medicine
Vice Chancellor for Health Affairs
University of Colorado