In the comments section of a recent blog post, a reader commented:
The idea of using a computer to aid in making a diagnosis is not new. When hand held PDAs came out in the 90′s, I was one of the first to download Epocrates to mine to aid me in making the most informed diagnosis if a particular patient’s symptoms or problems were complex, or hadn’t responded to my treatment. It is an expected outcome that as more and more data and information has become available in the ‘cloud’ that we as physicians will utilize it more often… But will a computer or cloud computing ever replace the value of face-to-face contact with a real physician or mid-level care provider. Patients are all so different and 90% of the art of medicine is taking an accurate history, which frequently requires getting patients to open up or share that one last symptom that they either forgot or were afraid to share for a variety of reasons. It can actually make the difference between life and death in some cases. I fully embrace the future of what cloud sharing offers all of us in any business or occupation. But there will still be no way to improve on the Marcus Welby, MD “model of medical practice.”
Despite my belief in the value of technology to support better patient care (The Avatar Will See You Now), I agree wholeheartedly with the central role of the internist. When I talk to physicians and inquire about their methods, I’m always fascinated by their intake process and the central role of patient history. As the writer says, “90% of the art of medicine is taking an accurate history.”
At a recent healthcare innovation workshop, a retired physician concurred that the patient history comes before the physical exam and lab tests in terms of diagnostic importance. An accurate history requires getting patients to open up and share the one last symptom that they either forgot or were afraid to share. Could technology ever be able to tap into the level of empathy that gives patients that feeling of safety and trust?
Yes, the impact of technology on healthcare is remarkable. Yes, it enables us to correlate and aggregate data, but at least at this stage, it’s still missing empathy and insight. Technology on its own will not be the best solution for that any time soon. Good physicians have the very human ability to look a patient deep in the eyes and create an environment of trust, transparency and openness – and to get that patient to tell them what they haven’t told anybody else.
The trusted relationship between doctor and patient is still the heart of medicine.