“How did you know what had happened to the patients?” I asked my friend.
“They wore little wooden amulets around their necks with notations like ‘TB 1968 Rxed with INH,’ ” he said.
“That’s it?”
“What more do you need?” he said, a wise comment I have always remembered.
Bonus Care
The computer hardware and software manufacturers would be bereft if we slowed down on the documentation; informatics is touted as the answer to all that ails modern medicine, and that is their business.
Personally, however, I would like to doctor more and document less and—God forbid—have the regulators trust me that I am delivering the services for which I am billing, even if I do not dot every “i” and cross every “t.”
There is a Southern word, lagniappe, which I always associate with New Orleans and its cuisine. Lagniappe is something extra, a bonus, an embellishment that makes life better.
In their interaction with the healthcare system, patients need lagniappe—a quiet, unhurried conversation with the doctor, a dietician describing how to spice up a low-salt diet with some Texas Pete hot sauce, a nurse washing an old lady’s thin gray hair.
In medicine, what can provide lagniappe?
Doctoring? Absolutely.
Documenting? Get real.
Dr. Pisetsky is physician editor of The Rheumatologist and professor of medicine and immunology at Duke University Medical Center in Durham, N.C.
