Skip to content
  • About
  • Contact
  • Contribute
  • Book
  • Careers
  • Podcast
  • Recommended
  • Speaking
  • All
  • Physician
  • Practice
  • Policy
  • Finance
  • Conditions
  • .edu
  • Patient
  • Meds
  • Tech
  • Social
  • Video
    • All
    • Physician
    • Practice
    • Policy
    • Finance
    • Conditions
    • .edu
    • Patient
    • Meds
    • Tech
    • Social
    • Video
    • About
    • Contact
    • Contribute
    • Book
    • Careers
    • Podcast
    • Recommended
    • Speaking

Doctors should start watching more science fiction. Here’s why.

Seiji Yamada, MD, MPH
Tech
December 12, 2017
239 Shares
Share
Tweet
Share

I often say that electronic health records (EHRs) is like Skynet in the Terminator. I expect to turn around from my screen someday, and Arnold will lift me by my throat saying, “You haff not been doing yuh meaningful use.”

We practice in a time when EHR confounds us by freezing, crashing and chaining us continuously to our work, as we spend evenings and weekends on documentation. For reimbursement purposes, we are instructed to include more and more useless details. As we pay more attention to the “iPatient” than to the real patient, we have confused the map for the territory. Is there a Dr. John Connor out there who will lead the resistance against Skynet EHR?

Perhaps instead it will be a hacker anti-hero that brings the whole system crashing down — an Elliott Alderson from Mr. Robot. Or perhaps a robot will herself take out the abusive, misogynistic corporate head, as Ava does in Ex Machina.

Alas, the machines are ascendant for now. Before we are liberated from robot rule, we will surely accommodate them further. Some advances in EHR do actually help us. For example, our hospital EHR won’t suggest a diagnosis of sepsis (though it could certainly calculate a sepsis-related organ failure assessment (SOFA) score), but once you choose the sepsis order set, it prompts you to repeat the lactic acid in three hours. Choose the order set for hospital-acquired pneumonia, and it prompts you to order antibiotics from the latest Infectious Diseases Society guidelines. However, as noted by National Nurses United:

Although these software programs may be called clinical decision “support,” and the embedded clinical practice requirements may be called “guidelines,” they often function as hard-and-fast rules that override physicians’ professional judgment as well as limit the full professional practice of nurses and other practitioners that care for patients.

No doubt there are techies who are working on making EHR more user- and patient-friendly. As long as we’re going to live inside The Matrix, can our user-friendly overlords at least make it pleasant for us, as Mr. Smith did for Cypher, and let us eat (synthetic glop that tastes like) steak?

The Terminator viewed the world through an interface that projected a variety of data real time in his field of vision — as if he had access to the internet of things. He had two hands free to do his thing, i.e., wreak mayhem. Can’t we have access to data on our patients in a way (a Google Glass-like display?) that allow us two hands free to do our thing? Or perhaps, like Tom Cruise in Minority Report, we could chart in the air in front of us.

In Homo Deus, Noah Yuval Harari contends that that artificial intelligence will soon augment human intelligence. How long before we will be able to instantly upload digital content from the National Library of Medicine? One can imagine a scene taking place in the near future in a remote hospital:

Nurse Neo to family doctor Trinity: Can you fix this subarachnoid hemorrhage?

Dr. Trinity: Not yet. (She speaks into her phone.) Tank, I need a program for the surgical approach to clipping an aneurysm. Hurry. (Her eyelids quiver briefly.) Let’s go.

However, when artificial intelligence merges with human intelligence, what role is left for the human physician? As technology advance, workers in nearly every occupation must fear being replaced by robots. The techies are certainly plotting to replace physicians altogether with robots. A robotic baby harp seal has been used as a stand-in for therapy animals in Japan since 2004. Will androids ever develop to the point where it will become difficult to tell them apart from humans, as in Blade Runner or Westworld? At that point, in what way can human physicians doctor better than androids?

Surely, the worth of the physician of the future will be their ability to carry out the human side of doctoring. A machine cannot comprehend a patient’s and family’s values. A robot without consciousness cannot understand the suffering caused by illness or the existential questions raised by life-threatening conditions. If artificial intelligence can figure out the right words to say, and the words are voiced by a life-like android — can such words console? Artificial intelligence cannot empathize. It cannot feel. On the other hand, might patients respond to a facsimile of empathy? Theodore Twombly falls in love with the operating system of his computer in Her.

The implications for medical education are that we must work to select individuals who are capable of doing these aspects of doctoring. Medical students should be evaluated less by their Step 1 scores and more by their ability to doctor. Future doctors should be interested in their patient’s feelings, their ideas about their illness, the effect that it has on their functioning, and their expectations of their medical encounter. We cannot simply depend on the natural empathetic characters of individuals. We must foster patient-centered skills in our future doctors.

Seiji Yamada is a family physician.

Image credit: Shutterstock.com

Prev

Think the world is in chaos? Focus on mental health.

December 12, 2017 Kevin 0
…
Next

Social media: The ultimate tool for women in medicine

December 12, 2017 Kevin 4
…

Tagged as: Health IT, Hospital-Based Medicine, Practice Management, Primary Care

Post navigation

< Previous Post
Think the world is in chaos? Focus on mental health.
Next Post >
Social media: The ultimate tool for women in medicine

More by Seiji Yamada, MD, MPH

  • Are post-apocalyptic disaster films inspiration for doctors?

    Seiji Yamada, MD, MPH
  • Here’s how a glucometer turned this doctor against Medicaid for all

    Seiji Yamada, MD, MPH

Related Posts

  • Here’s why doctors must know prescription costs

    Mark Kelley, MD
  • Is social media a friend or foe of science?

    Michael Joyce, MD
  • Why do doctors who hate being doctors still practice?

    Kristin Puhl, MD
  • Doctors: It’s time to unionize

    Thomas D. Guastavino, MD
  • Wellness initiatives can start in the medical library

    Sheryl Ramer
  • Take politics out of science and medicine

    Allison Neitzel, MD

More in Tech

  • A new era of collaboration between AI and health care professionals

    Harvey Castro, MD, MBA
  • What I think it means to be a medical student in the wake of AI

    Jackson J. McCue
  • The rise of generative AI in health care: Here’s what you need to know

    Anil Saldanha
  • Can AI solve the physician shortage crisis?

    Harry Severance, MD
  • Bridging the digital divide: How to bring trust back into the patient-physician relationship

    Arti Masturzo, MD
  • Can foundation AI models like ChatGPT and Google’s Bard be used for automating medical scribing?

    Dr. Sushindri Sridharan
  • Most Popular

  • Past Week

    • The real cause of America’s opioid crisis: Doctors are not to blame

      Richard A. Lawhern, PhD | Meds
    • Healing the damaged nurse-physician dynamic

      Angel J. Mena, MD and Ali Morin, MSN, RN | Policy
    • The struggle to fill emergency medicine residency spots: Exploring the factors behind the unfilled match

      Katrina Gipson, MD, MPH | Physician
    • Breaking the stigma: Addressing the struggles of physicians

      Jean Antonucci, MD | Physician
    • Beyond the disease: the power of empathy in health care

      Nana Dadzie Ghansah, MD | Physician
    • Deaths of despair: an urgent call for a collective response to the crisis in U.S. life expectancy

      Mohammed Umer Waris, MD | Policy
  • Past 6 Months

    • The hidden dangers of the Nebraska Heartbeat Act

      Meghan Sheehan, MD | Policy
    • The real cause of America’s opioid crisis: Doctors are not to blame

      Richard A. Lawhern, PhD | Meds
    • Nobody wants this job. Should physicians stick around?

      Katie Klingberg, MD | Physician
    • The fight for reproductive health: Why medication abortion matters

      Catherine Hennessey, MD | Physician
    • The vital importance of climate change education in medical schools

      Helen Kim, MD | Policy
    • Resetting the doctor-patient relationship: Navigating the challenges of modern primary care

      Jeffrey H. Millstein, MD | Physician
  • Recent Posts

    • Do residents deserve the title of physician?

      Anonymous | Physician
    • A new era of collaboration between AI and health care professionals

      Harvey Castro, MD, MBA | Tech
    • When an MBA degree meets medicine: an eye-opening experience

      Arthur Lazarus, MD, MBA | Physician
    • Why it’s time to question medical traditions [PODCAST]

      The Podcast by KevinMD | Podcast
    • The hidden gems of health care: Unlocking the potential of narrative medicine

      Dr. Najat Fadlallah | Physician
    • The realities of immigrant health care served hot from America’s melting pot

      Stella Cho | Policy

Subscribe to KevinMD and never miss a story!

Get free updates delivered free to your inbox.


Find jobs at
Careers by KevinMD.com

Search thousands of physician, PA, NP, and CRNA jobs now.

Learn more

View 2 Comments >

Founded in 2004 by Kevin Pho, MD, KevinMD.com is the web’s leading platform where physicians, advanced practitioners, nurses, medical students, and patients share their insight and tell their stories.

Social

  • Like on Facebook
  • Follow on Twitter
  • Connect on Linkedin
  • Subscribe on Youtube
  • Instagram

CME Spotlights

From MedPage Today

Latest News

  • Healing the Damaged Nurse-Physician Dynamic
  • Doc Moms, Mind the Gap -- $3M Earning Difference by Sex
  • Clinical Note Writing App Powered by GPT-4 Set to Debut This Year
  • Helping Patients Get Fit -- One Walk at a Time
  • TB Cases Rebound to Near Pre-Pandemic Levels, CDC Data Show

Meeting Coverage

  • Switch to IL-23 Blocker Yields Deep Responses in Recalcitrant Plaque Psoriasis
  • Biomarkers of Response With Enfortumab Vedotin in Advanced Urothelial Cancer
  • At-Home Topical Therapy for Molluscum Contagiosum Gets High Marks
  • Outlook for Itchy Prurigo Nodularis Continues to Improve With IL-31 Antagonist
  • AAAAI President Shares Highlights From the 2023 Meeting
  • Most Popular

  • Past Week

    • The real cause of America’s opioid crisis: Doctors are not to blame

      Richard A. Lawhern, PhD | Meds
    • Healing the damaged nurse-physician dynamic

      Angel J. Mena, MD and Ali Morin, MSN, RN | Policy
    • The struggle to fill emergency medicine residency spots: Exploring the factors behind the unfilled match

      Katrina Gipson, MD, MPH | Physician
    • Breaking the stigma: Addressing the struggles of physicians

      Jean Antonucci, MD | Physician
    • Beyond the disease: the power of empathy in health care

      Nana Dadzie Ghansah, MD | Physician
    • Deaths of despair: an urgent call for a collective response to the crisis in U.S. life expectancy

      Mohammed Umer Waris, MD | Policy
  • Past 6 Months

    • The hidden dangers of the Nebraska Heartbeat Act

      Meghan Sheehan, MD | Policy
    • The real cause of America’s opioid crisis: Doctors are not to blame

      Richard A. Lawhern, PhD | Meds
    • Nobody wants this job. Should physicians stick around?

      Katie Klingberg, MD | Physician
    • The fight for reproductive health: Why medication abortion matters

      Catherine Hennessey, MD | Physician
    • The vital importance of climate change education in medical schools

      Helen Kim, MD | Policy
    • Resetting the doctor-patient relationship: Navigating the challenges of modern primary care

      Jeffrey H. Millstein, MD | Physician
  • Recent Posts

    • Do residents deserve the title of physician?

      Anonymous | Physician
    • A new era of collaboration between AI and health care professionals

      Harvey Castro, MD, MBA | Tech
    • When an MBA degree meets medicine: an eye-opening experience

      Arthur Lazarus, MD, MBA | Physician
    • Why it’s time to question medical traditions [PODCAST]

      The Podcast by KevinMD | Podcast
    • The hidden gems of health care: Unlocking the potential of narrative medicine

      Dr. Najat Fadlallah | Physician
    • The realities of immigrant health care served hot from America’s melting pot

      Stella Cho | Policy

MedPage Today Professional

An Everyday Health Property Medpage Today iMedicalApps
  • Terms of Use | Disclaimer
  • Privacy Policy
  • DMCA Policy
All Content © KevinMD, LLC
Site by Outthink Group

Doctors should start watching more science fiction. Here’s why.
2 comments

Comments are moderated before they are published. Please read the comment policy.

Loading Comments...