I am disturbed by the current starry-eyed love affair with technology in health care. This blind faith in computers over physicians is destined to have tragic outcomes in the rare cases when machines cannot replace a face to face encounter with a living, breathing physician.
The "Future of Health Care" discussions making viral pronouncements like, "80 percent of what doctors do can be replaced by computer algorithms and cell phone apps" are misguided and dangerous. Here's why ...
The most important -- and often life-saving -- clinical decisions are made by physicians who are doing things that cannot be replaced by an algorithm.
They are called HUNCHES
One of the first things a doctor does, immediately and unconsciously is make this determination.
Is the patient
SICK or NOT SICK
We call it a hunch. It is so much more nuanced and sophisticated than that.
-- We use our whole body to get an energetic read on the patients presentation and story.
-- Filter it through our entire history of clinical experience.
-- For an instantaneous read on how urgent this situation could be.
Sick or Not Sick
This immediate determination is key to how we proceed from that point forward. The signs are often very subtle if we are asked to explain why we think this is a sick person. Yet this "read" of the patient is something all physicians are familiar with.
We all have at least half a dozen cases of sick patients where our immediate action saved a life then and there -- or caused us to really dig into the case -- above and beyond the usual workup -- to find a diagnosis that would have been missed otherwise.
Just think back for a moment on the cases you can remember that presented in this way in your practice.
Now what if that same patient had fired up a cell phone app instead of calling or seeing you. They are plugging through an algorithm they have been told is better than seeing a doctor, rather than giving you a call, driving to the ER or making an appointment.
The delay itself could cost them their life.
The incorrect diagnosis the app gives them -- remember these decision trees are based on probabilities and rare things happen all too often -- can cause a delay in seeking a doctor's opinion that can be fatal or have permanent and severe consequences.
The algorithms will work in the majority of cases -- until they get it wrong or delay the patient's presentation.
People will die in these interactions with technology unnecessarily. It will not be common AND It will happen.
A cell phone app is an easy example to point out and yet other eHealth technologies are no better. A text message, email or even a video house call can deny the physician the ability to make the clean determination of sick or not sick.
When a bad outcome happens, you will be left with...
"I wouldn't have missed this if I had been able to actually see and touch the patient."
So instead of a love affair with tech and eHealth, let's take a much more nuanced view of its proper place. Let's be more careful about how we present tech in health care in our articles and news programming. Let's make sure there are plenty of points in the algorithms where the next option is, "Go immediately to the ER," or "Call 911," or "Call your physician."
Let's always be aware of the exceptions to the normal presentations of disease and the rare and unusual ways people present when they are seriously ill. And let's stop the irresponsible "tech is the future and doctors are now obsolete" mantras.
Tech has its place
AND
Doctors have a vital role
And there are times when you are ill when you want to be sitting in front of a physician, not your smartphone. On occasion, that decision to seek the care of a doctor can save your life.
Dike Drummond, M.D., is a family physician, executive coach and creator of the Burnout Prevention Matrix Report with over 117 ways doctors and healthcare organizations can work together to prevent physician burnout. He provides stress management, burnout prevention and leadership development services to physicians through his website, TheHappyMD.com.