By GEORGE BEAUREGARD

Back in the late 90s to early 2000s, I had a robust (independent) internal medicine practice. These were the days before electronic medical records and hospitalists became ingrained into the healthcare delivery landscape. I’ll admit that—despite how much I loved my Palm Pilot—initially, I was ambivalent about the value-add of both. For many reasons, I felt that using an electronic health record (EHR) would serve as an improvement over paper records, but at what cost and effort? (Too many EHR users had already told me that, once you’ve used [a good] one, you’ll never go back. I did , however, promise myself that I would find a way to look at the patient sitting before me instead of staring at the screen.)

I was, however, skeptical about how an external physician, who, while clinically adept, didn’t know “the rest of the story” about my patients multi-dimensional stuff—life experiences, body language clues, hobbies, tendencies, cultural norms, etc.—could serve them better than me during their times of a health crisis. But I did know that the train had already left the station.

Like a great white shark fin, the concept of “Managed Care” and all of its attendant pros, cons, trials, and tribulations, had already broken through the surface of healthcare delivery and workflows, only to be forced into to a hasty retreat due to a tremendous backlash from enraged patients and physicians. (I mention this in a previous post: A Code Blue for Common Sense.)

Concurrently, I was leading a large independent physician network that was taking on risk-based contracts. To say that my synapses were firing in the high-speed lane would be an understatement.

Our network attorney was an interesting person and eventually, we became good friends. (In some ways he reminded me of a cross between Richard Belzer, Peter Capaldi, and Sam Elliot.) He was thoughtful, smart, articulate, and, when he spoke, people listened. And he didn’t suffer fools.

He invited me and my wife, Kathy, to dinner one night to he and his wife’s home in So. Dartmouth, MA. His elderly father, a retired physician, lived with them. When we arrived, Mark introduced me to his father, who was seated at a table. Although he appeared somewhat frail, he was well groomed and neatly dressed. When we shook hands, I noticed that he had a strong grip. He remarked about the firmness of my grip —as if it was a characteristic that he judged people by. I couldn’t help but notice that. on the tabletop in front of him, was the most recent issues of the NEJM and JAMA. They weren’t there for show: when asked about it, he said he read every issue, so he could “keep up with medicine”. (His son confirmed that he did indeed read every issue and could speak to them with accuracy later on.) He proceeded to ask me what I thought about a particular article about a COPD study that was in the NEJM issue. Thankfully, I had read it. I was impressed and thought: that’s a state of being that I’d like to find myself in during my septuagenarian or octogenarian years. Keeping up.

None of my adult children ended up in the medical field —a neutral reality, not a judgement or regret. Still, recovering from my recent hospital stay gave me time to reflect on how they navigate today’s sea of healthcare misinformation. I’ve been considering what I ought to do, if anything, to curate the information about medical advances that will (and might) actually matter to them: strategies for getting upstream of chronic illness, novel, diagnostic tools, new discoveries, and the real world impact of artificial intelligence in healthcare.

For the most part, physicians are data and information hungry people. We want to see the evidence.