In no other field is change received with so much resistance and skepticism than in medicine. The oath taken by physicians to “do no harm” is profoundly ingrained in the medical culture that any deviation from tradition is regarded as near blasphemy.
As a physician, I frequently catch myself relying on superstition and past experiences more than on evidence and proof of progress. As the world is witnessing an unprecedented technological boom, very few advances have infiltrated in the medical field. Certainly, bearing the heavy responsibility of a human life is an unparalleled privilege that physicians undertake with reverence. Nevertheless, accepting change and growth requires a strength of character and sense of humility that healthcare providers all too often hesitant to accept. Without a doubt, maintaining the status quo a comfortable position, while challenging it is not only adventurous but seemingly treacherous.
As a physician working in Silicon Valley, I am fortunate to be surrounded by brilliant engineers. Some of them, inevitably, become my patients. They are often the most educated and inquisitive of patients, and consequently, the ones who challenge us the most. While we can offer life-saving treatments, we are also often faced with an uncomfortable array of inquiries into what appears to surprisingly be a rather primitive discipline. While the conversation often is sparked by a curiosity about technological options such as robotic surgeries, it quickly and shockingly degrades to an alarming realization of the crude principles that continue to rule the medical field.
For example, while computers are nearly ubiquitous in the daily living of American people, much of medicine is still done on paper. Even though electronic medical records have existed for years, the focus has remained on billing and has not adapted to physicians’ needs. As wearable technologies such as smart watches and intelligent glasses have permeated through the population at large, the medical field has resisted assimilation of such devices on the basis of lack of proof for patient safety. Measuring differences in patient outcomes and the influence of smart technologies is seemingly impossible. The inconceivable complexity of human pathophysiology and ethical boundaries of medicine create intricate statistical puzzles that are difficult to solve. Yet, we fail to ask ourselves if failure to prove a positive change necessarily implies a compulsory futility of using such devices.
The most disheartening discussions with patients revolve around unveiling medicine’s simplistic culture of rank. The medical hierarchy appears to be nearly indestructible and instinctually hinders progress. One of the advantages of being cared for as a patient in an academic center, is that larger and more complex teams are composed of providers with various experiences — from medical students, to residents, fellows, junior and senior attendings. This continuous gradation of basic medical knowledge balances the years’ worth of clinical experience, such that a patient could be cared for in a sensible, comprehensive and prudent approach. Much too frequently, the real fear of questioning one’s superior hampers important conversations that would lead to good patient care. When suggestions are dismissed on the basis of tradition or fear of change, it is clearly a missed opportunity for progress.
As a resident, I am thrilled about the tremendous learning opportunities and technological advances that continue to inspire hope for new techniques and treatments. Nevertheless, at the same time, I cannot help but feel a gentle, yet constant, restraint for deviating from paved pathways. Certainly, medicine is the second most regulated industry in our country, and it takes a herculean effort to mitigate risk in a profession centers on life and death. Challenging the status quo ought to be an expected part of our culture. Respecting tradition and routine is just as paramount as embracing change, innovation, and creativity. After all, providing the most advanced care to our patients means acknowledging that “the only constant in life is change.”
Ioana Baiu is a surgery resident.
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