Doctoring The Transcript
Last week I outlined some communication problems I’ve been having with my primary care physician. I’ve had this doctor for about a year after my previous one unfortunately left Kaiser Permanente, and I chose them based in large part upon browsing the profiles Kaiser doctors have the opportunity to post online.
At any rate, this month I’ve been having a peculiar bout of lymph inflammation, first in my neck and then at my left collarbone, which caused a slight adjustment to our doing due diligence on the way toward an ME/CFS diagnosis in order to redirect me to get a new set of CT scans.
Thing is, that appointment isn’t until late November, and the somewhat related rheumatology referral isn’t until late December, and it had occurred to me to ask my doctor why we haven’t sent me for labs in order to rule out an infection.
Their answer, this evening:
I don’t suspect an infectious cause. Your white blood cell counts have been stable, and there aren’t any symptoms that would localize to a source of infection.
The two things to know about my white counts are that they are on the absolute low edge of normal, and that my last round of blood work was back in July. Somehow, we are using July labs to judge a lymph inflammation newly-acquired in October, apparently.
What’s more, after seeing a story about a medical transcription service powered by generative A.I. that was getting things wrong and making things up, I remembered that my doctor has asked my permission at each appointment to be recorded to aid their note-taking. I’d even wondered in therapy one day if the reason for my communication difficulties with this doctor wasn’t the reliance upon the app rather than taking notes by hand in the room.
I’ve mentioned before (this isn’t the best link but I can’t find it right now) that when “dealing with an authority figure of one sort or another, someone who could determine the course of my life in direct and profound ways”, especially when “in a small, suffocating room”, I sometimes “defer to the other”.
It simply never occurs to me in the heightened tension of a doctor’s appointment to ask about the app.
As it turns out, it isn’t the one in the article, but it is another app making use of generative A.I. So now I have to add to my stress the fact that I am going to have provide a blanket opt-out of any future use of the transcription app.
Don’t even get me started on the fact that for some reason replies have been turned off in messaging, so each time I need to continue an existing conversation with my doctor, I have to re-state to what I’m responding, making all of these exchanges even more fraught and ridiculous.
This was not my first choice for a new primary care physician. My first choice, which expressed a view toward medicine as social justice, wasn’t taking new patients when I needed to find a new doctor. They aren’t taking new patients now, either, but at this point I’d estimate that my chances of switching doctors has risen to about 72%.
Finding a doctor is an exhausting, anxiety-inducing experience, and I dislike the idea that I already might have to make another change.