“You don’t seem to be a computer doctor…” he said to me, looking almost surprised, several minutes after our visit began. “Well, there’s a computer right in front of me and I’m tapping away at it,” I said, not sure of whether this was a good thing or bad thing. Come to think of it, although I’ve owned Macs since the late 80s, I still consider myself pretty much a technophobe.
“Computer doctors hear but they don’t listen; they are engaged with electronics more than their patients. You’re not one of them,” he replied. Good to know. So, this was sort of a sideways compliment. He’s referring to the “digital wedge” that computers introduce between doctors and patients.
Have computers really helped patient care? One of the clear “pluses” for me is that I can actually read the thoughts of other providers without having to deal with terrible chicken scrawl penmanship for which doctors are notorious. I can also check drug-drug interactions faster than greased lightning, which has serious medical value. Computerized medical records have also been shown to:
- Streamline record keeping and reduce paper use
- Clarify communication and information transfer
- Improve access to records
- Increase efficiency of care
Unfortunately, all of this requires some serious effort, including on the part of busy providers, to enter data. And this seemingly teensy weensy issue has changed, maybe forever, the physician-patient relationship. In the words of Daily Beast writer Megan McArdle:
“Now instead of checking a box with a pen, she clicks on a box on her computer screen, waits for it to open, marks the appropriate checkoff, and then closes it. Repeat. Repeat. Repeat. Then close the patient’s file. Maintaining eye contact is a thing of the past.”
All this occurs instead of ruminating about patients and their problems and concerns. What has happened, albeit quite unexpectedly, is that computers have “taken the highest paid person in the department and turned [them] into a data entry clerk.” Even further, the sheer volume of forms that need completing have essentially turned our white coats into straitjackets. Is it any surprise then that patients have noticed that doctors spend gobs more time on the computer than with them?
A Kantian View
I see computers as a means to an end, and the end is better patient care. Computers should never be the center of medical attention, and will certainly never replace a well-tuned clinician. Like a stethoscope, they are simply tools to get the job done. As such, they should not interrupt the delicate and cherished intimacy between patient and provider that has existed for centuries. In the words of the beloved John F Kennedy: “Man is still the most extraordinary computer of all.”