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| "Self-portrait with a Portrait of Doctor Farill" (1951) by Frida Kahlo |
Most people were optimistic about integrating digital medical records more broadly into health care, but some worry that the presence of computers has had unintended consequences, including disruption of the doctor-patient relationship. What role should digital technology play in medicine? If experienced physicians are capable of drawing quickly from a deep well of knowledge and intuition, does that surpass the most advanced computer's ability to analyze massive amounts of data and offer "decision support" to those physicians? Are digital support tools even more useful for less experienced physicians? Or does the computer system hinder doctors' abilities to offer the most effective care? Is there a crucial human element in medicine that computers can never replicate?
One thing that really permeated with me was the fact that during a normal check-up the doctor's full attention is no longer on the patient.As someone who has sat through an exam I noticed how awkward it was (for me at least) to communicate with someone about my health who was constantly looking toward a screen. I believe there is a crucial human element to medicine and that is the fact that when you go to a doctor's office you are going to see a doctor, not a computer. Most likely, you have seen this person before and even if he doesn't remember your name or diagnosis he is able to see that information in his records. Going to the doctor is as much social as it is medical. You go to see the person. A doctor with a bad bed side manner isn't going to get many patients. I believe a computer takes away this component of medicine. One idea would be for the physician to take manual notes during the appointment and put the information in his electronic records directly after the appointment. This may mess with his timetable but I think it would create better doctor/patient relationships.
ReplyDeleteI think digital technology should play a role in medicine however in my own experience I would rather doing things manually. For example in class I write notes by hand instead of bringing my laptop because I can recall the information better by taking the time to think about what I am going to write.
I completely agree that it can be difficult to communicate with someone when they are completely engulfed in a screen. There is a crucial human element in medicine and technology disrupts that human relationship. I had the same idea of the physician taking physical notes during the appointment and then transferring them to electronic after the patient leaves. They could even have a nurse or other staff member make the conversion so that the doctor can go straight to the next patient. Technology is extremely helpful in medicine but it should mainly be used for saving and storing documents for future use.
DeleteDigital technology should mostly be for storing notes, records, prescriptions, etc. in medicine. Decision support is a bad idea. It reminds me of the Symptom Checker on WebMD or other medical website. By just entering a couple symptoms into the search engine, you are given numerous sicknesses and diseases that you could possibly have. What is actually just a sore throat from allergies, the computer thinks is laryngitis. Computers are not actual people and therefore should probably not be making diagnoses in doctor's offices. Digital support tools are even worse for less experience physicians because they rely on the machine instead of their instincts, learning, and experiences. Computers will never be able to replicate human instinct. Computers should be used for record keeping in medicine, but doctors should be responsible for the rest.
ReplyDeleteI think that physicians should develop the relationship with the patient and diagnose the patient themselves. I believe that a doctor’s knowledge far surpasses a computer’s ability. Like Brayden said, people type their symptoms into WebMD and it usually diagnoses them with something far worse than what they actually have. Computers, while sometimes capable, are not able to make decisions on a case by case basis as smoothly as a doctor would. Also, doctors go to school for eight or more years to learn all of the information they need. With the addition of technology, this knowledge seems to be irrelevant. I think machines should be used as a back-up when the physician is questioning their diagnosis.
DeleteIn a small town, however, I think that technology would be beneficial. If a person had an illness that required a specialist’s opinion immediately, the technology could diagnose the patient. This would allow the patient to receive medical care more pertinent to their condition than they would have without the technology. The actual specialist could then see the person and confirm or deny the diagnosis when the doctor could see the patient.
I think that you are right that technology should be used primarily for taking notes and record keeping, not diagonsing patients.
DeleteI agree with the other comments that technology should take a backseat in medical practice, for the sake of the patients and the doctors. I can image that it would be frustrating to go through intense medical school only to have a computer tell you what to do. I also agree that humans are needed for the social side of medicine. As of now, computers do not have emotions. They cannot show sympathy and understanding. This is what I consider one of the most important roles of doctors. While a doctor’s primary goal should be to help people, many people can’t be saved. There’s a reason so many people are afraid of death. Doctors and nurses should be there to comfort people. I know that it is possible that someday a robot may be able to show emotion, but for now, this is was makes human doctors and nurses invaluable.
ReplyDeleteI think that digital technology should play the role of the sidekick and assist the doctor to do his or her job, not do it for them. I believe that a very good and experienced physician is more effective than a computer, because they draw knowledge and insight from past experiences and the patient’s emotions rather than just facts. Digital support tools can be useful in getting newer doctors acquainted, but it can also make it harder for the physicians to learn from experience. Computers cannot replicate the relationship that patients have with their doctors. I believe that this is a very important relationship, because it makes the patient more comfortable and the patient might actually tell the doctor more information if they are more relaxed.
ReplyDeleteMy mother is a physician and I was practically raised in a hospital. I have witnessed, on multiple occasions, doctors googling symptoms and potential diagnoses. In a place like an ER, hundreds of people come in everyday with a plethora of different problems. I do not expect my doctor to be a medical encyclopedia, however I do expect my doctor to be well-trained and knowledgeable enough to use any resource they have to make a diagnosis and start a treatment plan. No doctor is above consulting a computer for "decision support". Medical school is designed to teach you how to figure out a problem and to evaluate the validity of the resources used. As long as the computer remains the tool and the human remains the doctor, I do not see it hindering doctors' abilities to offer the most effective care.
ReplyDeleteAs a future doctor the fact that medicine has a probability of being automated is terrifying, medicine is the one occupation I have always seen to be safe from the clutches of "efficiency."
ReplyDeleteIf we are willing to sacrifice the empathetic disposition doctors are known to carry with then, I fear medicine may change for the worst. However, if we can properly integrate computer aids into medicine then they can lend a much needed hand to weary doctors without negatively affecting their cognitive processes.
I completely agree with your comment. Automation within medicine is not what scares me; the medical field being ONLY automation and having doctors who act like robots (or doctors who ARE robots!) for fear of losing their job or being sued for trying something new is what I find so terrifying.
DeleteI think it's amazing that we have machines to count medicine for patients now, computers for pharmacists to determine whether or not their patients are adhering to their prescriptions, and all of the incredible tools and machinery surgeons are able to use for procedures. These are all parts of medicine and surgery that I love and reasons for which I am training to be a surgeon.
My younger sister and brother were born with Familial Exudative Vitreo-retinopathy (a rare, genetic eye disease) and thanks to several surgeries and the advanced automation in medicine, they both can live normal lives. Hannah even drives, despite only having one eye. If the world is okay with losing doctors who have compassion for their patients, I'll just self-medicate.
If experienced physicians are able to access massive amounts of data, it could be for better or worse. For example, given that these physicians are already well-rehearsed in their trade it could make it easier for them to gain information about new medical techniques and discoveries that perhaps they were not yet aware of. However, it could also enable these physicians to be lazy and afford to rely on the computers more heavily for decision making rather than making that call based off their own expertise. Like Carr explained, it might have the unintentional effect of making the process of evaluating patients too convenient. The physicians could be tempted to stick with the generic or routine questions provided by the computer during appointments. Automation could be a very useful tool to doctors who are aware of its positive and negative influences on the health care system, but it could also be misused in a lazy way like we tend to misuse other technology or services that are capable of making certain processes in our lives more convenient.
ReplyDeleteIn 2013, Mercy Health went digital across the board. Every hospital and clinic under the Mercy brand went to a new system called Epic. While at first the system was difficult to understand, the staff finally assimilated to the system. The ability for healthcare professionals to be able to access is invaluable. When people come into the emergency room, physicians often have trouble drawing up a medical history, mainly because patients are often withholding information due to a lack of trust. With a system that contains a massive records database, physicians can fetch a prescription's list, medical history, family medical history, and many other records that are vital to making a proper diagnosis. Carr's idea of a system charging more by reminding physicians about certain procedures is far fetched, but it is something that could be very useful. Physicians are often under moderate to severe stress, so it is beneficial to them that a system would be able to detect and remind doctors. After all, doctors are only human.
ReplyDeleteThe last time I went to the doctor to get a refill on a prescription it took 10 minutes. Over half of that time was spent sitting and waiting for the doctor to finish completing his electronic checklist on his computer. The Hippocratic Oath states “do no harm” and yet doctor’s no longer look, listen or communicate with their patients the way they have in the past. So, I believe the role of digital technology should be focused on:
ReplyDelete• Emergency Access to Health Records - If I am in a car accident a doctor should be able to pull electronic health records to immediately see if I have any pre-existing conditions or allergies that would contraindicate any care or treatment.
• Preventative Testing - Every year each person should have baseline testing done to monitor their health and identify any problems as early as possible. Now more than ever, we are aware of the importance of receiving treatment in the early stages of disease.
• Diagnostic Data – Doctors can draw from a deep well of knowledge but still rely on diagnostic testing to narrow down and confirm a diagnoses.
Doctor’s should use technology as a tool to be wielded and not rely on it as a partner.
My mom is a medical transcriptionist. Which means, she types the doctors dictations for them to put into their medical records. She is a huge part of the organization of doctors. However, about 6 years ago, most doctors starting going to VR systems where the human transcriptionists were taken out of the equation. Fast forward to today, 6 years later, many doctors are reverting back to the human transcriptionists. Why would this be? They changed to the VR system in order to cut out the "human error", so why wasn't the computer system perfect and without error? I believe the doctors reverted back to the old ways because the computer systems were always guessing, when a human transcriptionist can just hear the correct word and type it. The VR systems worked like autocorrect, the doctors had to be extremely careful not to say one word that sounded like another.
ReplyDeleteComputers have most definitely affected the patient doctor interaction. I have experienced a doctor talking into a screen instead of looking and talking to me. I have also experienced a doctor talking and looking at me instead of just punching buttons into a computer the whole visit. The doctor who earned my trust was the doctor who talked to me and acted like they cared. Which is extremely important for the Health Care System.