Preserving the doctor-patient encounter in the face of technology

I recently was on vacation in Rocky Mountain National Park. Suspended on an overlook of astonishing beauty at 11,000 feet above sea level, I stared out at the tundra and bits of August snow that still clung to the highest peaks. Suddenly my attention was snapped from the massive boulders and landscapes to the ringing of my cell phone. It was a referring doctor asking me about a mutual patient with uncontrolled high blood pressure who needed to be seen as soon as possible.

The good thing about mobile communication devices is that just about anyone who has your number can you reach you anytime and almost anywhere. That’s also the bad thing. I know — I should have turned it off, but I had forgotten. I politely explained to the doc that I was out of town, but would let my office know that the patient needed to be seen that week.

As many things in life, technology offers both improvements and harmful distractions. No longer do I have to tell my family and friends where I am going or how I can be reached — they simply call, email, or text me. Gone are the days of pagers, (which I curiously still see on the hips of some doctors––probably the same ones without an EMR or office fax machine), but largely everyone has a cell or smart phone.

I often joke that as an aging physician, I am confronted by two diverting curves on a graph, each one heading in opposite directions. One is the number of useful synapses left in my brain plotted on the horizontal axis, against my chronological age, on the vertical axis. That curve is heading down. The other has the same aging axis, but lists the number and types of new technological devices and inventions. This curve is heading north. I’m not sure when it happened, but I am guessing the lines crossed a few years ago.

Instant informational access is a two-edged sword. On the one hand, I do believe that smart phones and tablets and a good EMR, improves the speed and quality of patient care. However, the Internet has opened up a veritable Pandora’s box of self-diagnosis options for my patients as well. Or as my sister likes to term it, “Dr. Internet.” I remind my patients about the old saying of “A little knowledge can be a dangerous thing,” but most of them then look at me in mild shock or disbelief. It is as if they are thinking, but not saying, “I know you went to medical school and did all that training for all those years, but I think WebMD is just as smart as you are.” To which I think silently, “So if everything you need to know is on the World Wide Web, then why are you here?”

Mind games aside, I believe that I have kept up with the technological advances in medicine, and am convinced that the benefits outweigh the risks, (such as device addiction, distraction, and depersonalization). However, the doctor-patient face-to-face, (not FaceTime) relationship, must be preserved. Technology, in whatever form, is just a tool, and like any tool can be used for good or well, Angry Birds.

David Mokotoff is a cardiologist who blogs at Cardio Author Doc.  He is the author of The Moose’s Children: A Memoir of Betrayal, Death, and Survival.

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