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Has Medicine Become Too Reliant on Technology?

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Medicine is both too reliant a technology and not reliant enough. And so one of the challenges we have is to find the sweet spot, where we are using technology appropriately, in the right way for the magical things that it can do and yet not reflexibly relying on it when there are other things that can work as well or better and are certainly far cheaper.

Where it's not reliant enough is computerised order entry, barcoding. There should be in our healthcare system, a single medical record that knows everything about me, and it doesn't matter whether I'm going to my local hospital across town or I'm in a car accident 3000 miles away, that the technology has the information that a doctor or nurse needs to have to take care of me effectively, and does more than that.

Right now, I think we are thinking of computers as large filing cabinets or large prescribing pads. Ultimately, we want the computer to be this repository of knowledge that actually can signal me. There's no way in a million in years that I can keep up with the medical information in my field.

It's just, it's coming out too quickly. And so, what we need is a computer system that I not only put information into but when I say I think this is a patient with pneumonia or septic shock, it can trigger me and say the best treatments for that are this, or it can say I see that you're saying that this patient has septic shock but are you sure that this isn't tularemia, or are you sure this isn't some odd disease that you haven't thought of, that can prompt me that way.

So in that way, we need more technology and better technology and more user friendly technology. On the other hand, we are entering to this risky period where we are beginning to get that type of technology, but it's extra ordinarily seductive and we will see patients now and I see them among my trainees.

And the patient will come in and say I have a headache and reflexively the patient gets a CAT scan. And we now not know that not only is that expensive, but there are some people that are going to get cancer from all of the radiation. And so, this instinct that we have to get a lab test, do an x-ray study, I think we have to fight it because not only is it expensive and sometimes distracting, and sometimes gives us the wrong answer, but it's intensely depersonalizing.

And so how do we figure this out? How do we use the technology in ways that really do help us deliver better, safer and less expensive care, at the same time recognize that I'm not taking care of somebody's medical records, but I'm actually taking care of a real person with fears and insights and for whom listening to them may actually yield the answer.

For whom the physical exam may actually give me some clue that's decisive that I can not get from the lab test or the x-ray. Trying to figure out how you find out that sweet spot, I think that's the work of those of us who are educators today. And I think so the answer is both of those we have to figure out how to come up with just the right technology, use it just the right way but never forget that there's a real person that we're taking care of.