Favorite Quotes
"For every complex problem, there is a solution that is simple, neat, and wrong." - HL Mencken
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"I hear and I forget. I see and I remember. I do and I understand." - Confucius
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"The good physician treats the disease; the great physician treats the patient who has the disease" - Sir William Osler
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" The best test of a person's character is how he or she treats those with less power." - Bob Sutton
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"Those are my principles, and if you don't like them - well, I have others." - Groucho Marx
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"The difference between genius and stupidity is that genius has its limits." - Albert Einstein
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"It is hard enough to remember my opinions, without also remembering my reasons for them" - Friedrich Nietzsche
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"Anyone can make the simple complicated. Creativity is making the complicated simple." - Charles Mingus
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"Not everything that can be counted counts, and not everything that counts can be counted." - Albert Einstein
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"A foolish consistency is the hobgoblin of little minds, adored by little statesman and philosophers and divines. With consistency a great soul has simply nothing to do." - Ralph Waldo Emerson
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"This ain't no party, this ain't no disco, this ain't no fooling around." - Talking Heads, Life During Wartime
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"What is hateful to you, do not do to your neighbour. This is the whole Torah; all the rest is commentary. Go and learn it." - Hillel, Talmud, Shabbath 31a
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"You will never understand bureaucracies until you understand that for bureaucrats procedure is everything and outcomes are nothing." - Thomas Sowell
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"An idealist is one who, on noticing that a rose smells better than a cabbage, concludes that it will also make better soup." - HL Mencken
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"If you only have a hammer, you tend to see every problem as a nail." - Abraham Maslow
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"A great teacher is one who realizes that he himself is also a student and whose goal is not to dictate the answers, but to stimulate his students creativity enough so that they go out and find the answers themselves." - Herbie Hancock
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"There are no facts, only interpretations." - Nietzsche
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"An education isn't how much you have committed to memory, or even how much you know. It's being able to differentiate between what you do know and what you don't." - Anatole France
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"In character, in manner, in style, in all things, the supreme excellence is simplicity." - Henry Wadsworth Longfellow ====
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Dec - 19
Jan - 21
Feb - 8
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Computers cannot practice medicine
10 Jan2010
Some computer experts think they could – The Next Health Care Revolution, From Dr. Google
So when you show up at the doctor with some set of symptoms, in my ideal world what would happen is that the doctor would type in the symptoms he or she also observes, and it would be matched against the data in this repository. Then this knowledge engine would use best practices, and all the knowledge in the world to give physicians some sort of standardized guidance. This is a generalized form of the checklists that you're talking about."
Then Schmidt made clear what was troubling him. "As computer scientists, this is a platform database problem, and we do these very, very well, as a general rule. And it befuddles me why medicine hasn't organized itself around these platform opportunities."
Obviously this computer expert has no concept of the complexity of human beings. We human beings describe the same symptom with different words. We human beings cannot estimate time. Sometimes patients exaggerate; patients vary in how they respond to the same stimuli.
Patients rarely present with single problems. The complexity of our diagnostic tasks cannot be described as a database problem Patients have psychosocial overlay. Patients have complicating issues.
When the physician and the patient meet, the physician must use eyes, ears, touch and occasionally smell. Body language matters. Facial expressions matter.
Sorry computer guy. This problem requires humans. Computers can assist us, but they cannot do our job. Computers cannot reassure patients. Computers cannot deliver bad news. I do not even think that computers can teach patients about their disease.
I love computers. I love electronic records. But computers will rarely help us with diagnosis, and then only when the physician filters the inputs.
Related posts:
- Is medicine worth it?
- Retainer medicine – from 7 years ago
- Retainer medicine – a patient’s view
- Matthew Holt on health care reform
- 15 days at the VA – day 10
Related posts brought to you by Yet Another Related Posts Plugin.
- In: Medical Rants
5 Responses to Computers cannot practice medicine
Pieter Kubben, MD
January 10th, 2010 at 1:18 pm
I fully agree with you. We do need Decision Supporting Systems, we do not need Decision Making Systems. Just like I'd prefer a pilot in the cockpit of my airplane… and medicine is even tougher, I guess.
uberVU - social comments
January 10th, 2010 at 1:30 pm
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This post was mentioned on Twitter by medrants: From My Blog: Computers cannot practice medicine http://is.gd/616eI...
Vince
January 11th, 2010 at 4:16 am
One of them should fix computerized charting (at least where I work, which got a "new" system a year ago) before even considering this next quantum leap. Our EMR is a godsend for pulling up old info, but like you said, the requirement to quantify/qualify everything about the patient using check boxes is a far cry from the real world. What's the point of the dozens of boxes for each section if I just end up describing the situation again in a comment box or selecting "other" because it doesn't fit neatly. Don't even get me started on the Windows 95 (at best, closer to 3.0) interface. It's 2010, this charting system that is supposedly "constantly being updated from our input" could really use a facelift to make it more appealing and increase its usability.
Sorry for the rant, it looks like our ED census is heading back up after a post-flu lull.
S Silverstein
January 11th, 2010 at 6:36 pm
I also commented along the same lines at the Healthcare Renewal blog in a post "Does the CEO of Google Use Google? – And: Platform, Platform, Who's Got The Platform, available at http://hcrenewal.blogspot.com/2010/01/does-ceo-of-google-use-google.html .
I extended the analysis to pharma, also characterized by non-medical IT "know it alls" about medicine.
Ming Jack Po
January 15th, 2010 at 8:16 pm
I think in the short term, Decision Support Systems will be where IT and Medicine converge. In the long term though, I'm not sure why you think Decision Systems can't be a reality?