By Dr. Kate Scannell, Syndicated Columnist
First Published in Print: 01/07/2012
Is it OK for an anesthesiologist to play Angry Birds on his iPhone while administering anesthesia during a gallbladder surgery? During your gallbladder surgery?
What do you think about a surgeon voice-dialing her colleagues or chatting with family during the operation?
Although we've inhabited the Digital Age for many years, only recently have we begun to examine how it might affect us personally as patients and doctors, and whether overall patient safety and care have actually improved.
This inquiry is long overdue, and, as recent studies suggest, urgent. Currently, more than 80 percent of physicians carry smartphones, and about one-third use tablet computers like iPads to "e-Doctor" -- that is, to access patient data, order drugs and tests, enter information into the electronic medical record, consult with peers, search Internet references, and send e-mails to patients and colleagues.
But the pervasive use of these e-devices has generated worries about digitally distracted doctors endangering patient safety. Multi-tasking and repetitive interruptions have been implicated as major causes of clinical inefficiency and medical error -- ironically, two central problems in health care systems that the Digital Age was supposed to address.
In this regard, the New York Times recently published an investigative look into "distracted doctoring" -- a newly described phenomenon drawing the attention of doctors and patient safety experts. It recounted troubling stories about doctors using e-devices for "Amazon, Gmail, ... all sorts of shopping" while on duty. In one case, an allegedly distracted neurosurgeon settled a lawsuit involving a patient who was left partially paralyzed after an operation during which he had used a wireless headset and cellphone to speak at least 10 times with family or business associates.
Like most new health care technologies -- "the newest hip replacement!" or "the next-Gen proton beam machine!" -- e-Doctoring devices were enthusiastically embraced by the medical community before long-term patient safety and clinical effectiveness data were collected and analyzed. The robust adoption of e-Doctoring devices gained momentum not only from the forceful positive spin regularly placed on any new medical technology, but also from the broader social revolution advancing the use of electronic devices.
Now, e-Doctoring devices are here to stay because, "for better or for worse, and in sickness and in health" we doctors have become wedded to them.
But the wedding of doctors and devices has left many patients feeling jilted. Increasingly, we hear about the demise of "the doctor-patient relationship." Patients complain about physicians ignoring them in clinic, preferring instead to interact with computer screens. They anxiously wonder why doctors so rarely touch and examine them anymore, all the while they finger iPads to order tests and prescribe medications. Patients don't understand why so many physicians have withdrawn from private and direct communication about their intimate health care concerns, relying instead upon "information exchanges" through email or third-party intermediaries. Many patients feel that they are being treated as mere data points.
Perhaps we are muddling through a major cultural shift that, in time, will reshape our expectations of medical care and conform to e-Doctoring's evolving relational consequences. But, in the present, we are slouching toward a vague awareness of what it may actually mean to be iPatients and iDoctors.
One of my nieces is contemplating medical school, and she asked me for advice about preparation. I surprised myself by responding that she needed to be adept with "all things computer, all things digital." She reminded me that most people her age were born as cyborgs, having seamlessly integrated technological enhancements and e-functionalities with their day-to-day being in the world.
"Yes," I replied. "But you never learned how to turn those things off. So I am not conceding your mastery of them until you can." I told her about my own struggles with techno-addictions, and how my dependence upon devices at work and at home often numbed my mind.
But unlike my niece, I had had experiences of living life without perpetual interconnectedness and e-distractions. I knew and valued how it felt to be connected to myself and other people, independent of electrical devices and synthetic channels.
For many physicians nowadays, the boundary between home and work has become so porous that the personal and professional cannot be neatly separated. Physicians are encouraged to stay connected 24/7 to their email through e-devices. Many are provided with take-home laptops that enable them to work "after hours." in their homes. Several of my physician friends claim that their children must compete with those laptops for attention.
Given so little separation of the living room from the medical office, perhaps we shouldn't be too surprised when our doctor reads a text message from her child in the middle of our scheduled appointment.
No one yet really knows how patient safety and clinical efficiency will ultimately fare under e-Doctoring. Hopefully, burgeoning interest in these issues will lead to useful insight. But in the muddled meanwhile, we should also be asking questions about what e-Doctoring is doing to us as people. How it is affecting our experiences as patients and doctors, both together and apart.
======================================================
Kate Scannell is a Bay Area physician and the author most recently of the novel "Flood Stage."
© Copyright 2012, Kate Scannell
First Published in Print: 01/07/2012
Is it OK for an anesthesiologist to play Angry Birds on his iPhone while administering anesthesia during a gallbladder surgery? During your gallbladder surgery?
What do you think about a surgeon voice-dialing her colleagues or chatting with family during the operation?
Although we've inhabited the Digital Age for many years, only recently have we begun to examine how it might affect us personally as patients and doctors, and whether overall patient safety and care have actually improved.
This inquiry is long overdue, and, as recent studies suggest, urgent. Currently, more than 80 percent of physicians carry smartphones, and about one-third use tablet computers like iPads to "e-Doctor" -- that is, to access patient data, order drugs and tests, enter information into the electronic medical record, consult with peers, search Internet references, and send e-mails to patients and colleagues.
But the pervasive use of these e-devices has generated worries about digitally distracted doctors endangering patient safety. Multi-tasking and repetitive interruptions have been implicated as major causes of clinical inefficiency and medical error -- ironically, two central problems in health care systems that the Digital Age was supposed to address.
In this regard, the New York Times recently published an investigative look into "distracted doctoring" -- a newly described phenomenon drawing the attention of doctors and patient safety experts. It recounted troubling stories about doctors using e-devices for "Amazon, Gmail, ... all sorts of shopping" while on duty. In one case, an allegedly distracted neurosurgeon settled a lawsuit involving a patient who was left partially paralyzed after an operation during which he had used a wireless headset and cellphone to speak at least 10 times with family or business associates.
Like most new health care technologies -- "the newest hip replacement!" or "the next-Gen proton beam machine!" -- e-Doctoring devices were enthusiastically embraced by the medical community before long-term patient safety and clinical effectiveness data were collected and analyzed. The robust adoption of e-Doctoring devices gained momentum not only from the forceful positive spin regularly placed on any new medical technology, but also from the broader social revolution advancing the use of electronic devices.
Now, e-Doctoring devices are here to stay because, "for better or for worse, and in sickness and in health" we doctors have become wedded to them.
But the wedding of doctors and devices has left many patients feeling jilted. Increasingly, we hear about the demise of "the doctor-patient relationship." Patients complain about physicians ignoring them in clinic, preferring instead to interact with computer screens. They anxiously wonder why doctors so rarely touch and examine them anymore, all the while they finger iPads to order tests and prescribe medications. Patients don't understand why so many physicians have withdrawn from private and direct communication about their intimate health care concerns, relying instead upon "information exchanges" through email or third-party intermediaries. Many patients feel that they are being treated as mere data points.
Perhaps we are muddling through a major cultural shift that, in time, will reshape our expectations of medical care and conform to e-Doctoring's evolving relational consequences. But, in the present, we are slouching toward a vague awareness of what it may actually mean to be iPatients and iDoctors.
One of my nieces is contemplating medical school, and she asked me for advice about preparation. I surprised myself by responding that she needed to be adept with "all things computer, all things digital." She reminded me that most people her age were born as cyborgs, having seamlessly integrated technological enhancements and e-functionalities with their day-to-day being in the world.
"Yes," I replied. "But you never learned how to turn those things off. So I am not conceding your mastery of them until you can." I told her about my own struggles with techno-addictions, and how my dependence upon devices at work and at home often numbed my mind.
But unlike my niece, I had had experiences of living life without perpetual interconnectedness and e-distractions. I knew and valued how it felt to be connected to myself and other people, independent of electrical devices and synthetic channels.
For many physicians nowadays, the boundary between home and work has become so porous that the personal and professional cannot be neatly separated. Physicians are encouraged to stay connected 24/7 to their email through e-devices. Many are provided with take-home laptops that enable them to work "after hours." in their homes. Several of my physician friends claim that their children must compete with those laptops for attention.
Given so little separation of the living room from the medical office, perhaps we shouldn't be too surprised when our doctor reads a text message from her child in the middle of our scheduled appointment.
No one yet really knows how patient safety and clinical efficiency will ultimately fare under e-Doctoring. Hopefully, burgeoning interest in these issues will lead to useful insight. But in the muddled meanwhile, we should also be asking questions about what e-Doctoring is doing to us as people. How it is affecting our experiences as patients and doctors, both together and apart.
======================================================
Kate Scannell is a Bay Area physician and the author most recently of the novel "Flood Stage."
© Copyright 2012, Kate Scannell