Jul 23 2013

Guest Post: Using MyDirectives in My Practice

Guest Post by Dr. Ryan Neuhofel

As a family physician one of my primary roles is planning for the future. Helping people live long, productive and healthy lives is what drives me every day. I try to catch diseases before they show signs and symptoms. I prescribe medications to prevent chronic diseases from ravaging the body. I tell people to wear life-jackets when boating.

Unfortunately, much like a financial advisor giving advice on the stock market, things don’t always go according to plan.

Even as a young physician, I have witnessed many tragic and untimely deaths. After witnessing just a few heart-wrenching family squabbles over an imminent death, I recognized the importance of emergency and advance care planning. Most people don’t like to consider those messy situations until it’s too late – after the diagnosis or the accident.

I get it. It’s not my idea of a relaxing Thursday evening either.

Throughout my years of training and practice, I have recommended hundreds of patients consider and document their medical wishes. Sadly, I’m guessing only a handful of people turned my advice into action. Completing a comprehensive and thorough advance medical directive document can be a daunting task. Even people who understand its importance, usually avoid doing so because of time or money constraints. Without specific resources or instructions, my recommendations were rarely fruitful.

In 2011, I started a solo, direct primary care family practice: NeuCare Family Medicine. I created a high-tech, yet old-fashioned, practice that was nearly paperless. I now do house calls by car and by webcam. New patients register online; completing standard demographics and health history.

Upon registration I ask about existing advance medical directives. Not surprisingly, only 5-10% of my patients have anything more than an organ donation preference. While I continued to recommend many patients create an advance directive at their initial visit – I struggled to give them good resources to complete this task. I tried recommending several paper templates, but their legal-ease was confusing and overwhelming -- and ended up in the garbage.

Then I discovered

MyDirectives made things shockingly simple. Their interactive questionnaire was thorough, on-point and written in plain English. It was basically like having a conference with your doctor and attorney -- a frightening and expensive proposition in real life, made easy and painless by MyDirectives. Once done answering some straightforward questions, a complete advance medical directive is promptly presented.

Directives hidden in a dresser-drawer aren’t much use. The high-tech sharing feature is what really makes MyDirectives shine. Patients can share their document with family, friends and their doctors.

After reaching out to MyDirectives, I was contacted by their team who advised me on how to integrate their service with my practice. After encouraging people to check it out on my blog, I had several patients complete their directives for the first time. Using our code or link, our patients can automatically share their document with us; so we can add it to their medical records. Also, we have inserted MyDirectives into our online registration in an effort to get all new patients on-board.

I haven’t yet convinced everyone to create and share an advance medical directive -- but at least now they do not have an excuse not to complete their directive.


Dr. Ryan Neuhofel (Dr. Neu) was born, raised and (mostly) educated in Kansas. After serving as Chief Resident in Family Medicine at KU-Med in Kansas City, he promptly moved to the coolest town on either side of the Mississippi to start NeuCare. He now lives in Lawrence with his wife, 2 kids and 1 Labrador Retriever. When not cleaning up after his children or dog, he enjoys cooking, fine ales and the great outdoors.


Dr. Neu NeuCare Ryan Neuhofel

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