A Computer Can?t Do That!

Monday, April 8, 2013 | Joel Sauer

Recently a colleague of mine gave a presentation at a scientific conference and made the bold statement, “We can only have one clinical standard – period.”  Afterward she was challenged by a cardiologist in the audience that such a position is taking away critical thinking on the part of doctors; in other words, limiting their ability to practice their art.  Undaunted she pushed back asking, “Who gets to decide whether to leave the plan and when?” His reply was almost immediate:  good doctors.  Just as quickly he realized the flaw in this logic.

In this era of electronic medical records, computerized order entry, Appropriate Use Criteria, care plans and the like, it can look like a full-on “attack of the machines” for physicians.  Let’s be blunt: we ARE trying to replace certain aspects of physician decision-making with machines and algorithms.  The truth is these tools do a better job following orders – every single time.  The data here are irrefutable.

Regardless of where the ultimate line between art and science gets drawn, there are certain things that only the human physician can provide.  Ever.  Hands-on touching, comfort, empathy and caring are just a few examples of job security for doctors.  In his recent TED Talk (http://www.ted.com/talks/abraham_verghese_a_doctor_s_touch.html) Abraham Verghese, an infectious disease specialist at Stanford, notes that the greatest innovation in medicine over the next 10 years will be the physician’s hand.

Sounds ridiculous in this digital era of exponential technology advances, but his point is that medicine has gotten backwards with technology leading and the human doctor following.  This has led to the explosive use of high-tech diagnostics and treatments, often at the expense of the physical exam and often of no true benefit to the patient.  Says Dr. Verghese, “I joke, but I only half joke, that if you come to one of our hospitals missing a limb, no one will believe you till they get a CAT scan, MRI or orthopedic consult."

There is certainly a place for technology and machines in medicine and, when properly utilized, they have the ability to improve the human condition.  Likewise, there is an irreplaceable role for the human physician and there is no onslaught to remove the healing touch only a doctor can provide.  Thus, physicians should embrace the use of computers and care plans.  They liberate you from the rote “if, then” process of science, providing more time to practice your art.

Notes Dr. Verghese, “We seem to have forgotten... the message, ‘I will always, always, always be there; I will see you through this; I will never abandon you; I will be there until the end.’”  Let’s see a machine do that!

 

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