Trust your senses as much as technology when making diagnoses

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I'm a big fan of technology. I enjoy all the latest gadgets like my laptop, my electronic reader and especially my cell phone. In fact, I'm rarely without my iPhone at work, as I've found a number of applications that make my job easier. I can look up drug dosing guidelines and interactions or search for information on an obscure disease without leaving the exam room. Many practices are moving towards electronic medical records (EMR) that can streamline so much clinical data and help reduce medical errors and storage issues while improving accessibility.  

Almost daily there is some new technology emerging to make health care providers' lives easier and our care more efficient or cost effective. I get excited when I hear about the latest advances. But have providers come to depend on technology so much that we are forgetting the most basic senses needed to diagnose and treat patients? 

I was reminded of this recently while working with a resident at the hospital. We were admitting a laboring mom and when the resident asked me what the presenting part of the baby was, I told her the baby was cephalic (head down). I laughed when she asked if I had used ultrasound to confirm this finding. I had no doubt that I had felt a head when I checked the patient's cervix — but then again I've been doing this for a while, and I trust my hands.  I appreciate ultrasound to confirm my findings when I suspect a breech or other malpresentation, but I do not routinely use it to diagnose what my hands already know. 

As much as I appreciate my gadgets, basic assessment skills are based on sight, hearing, touch and even smell. Any midwife or seasoned labor and delivery nurse knows the sound of a laboring mom pushing spontaneously — no instrumentation needed.  Technology tries to provide “better” methods, but there are some skills that technology cannot replace.

Despite the benefits of technology, I worry that moving to EMR means that providers will be looking at a screen rather than at the patient while taking a medical history.  How many non-verbal clues will be missed?  I'm concerned that we will forget how vital therapeutic touch can be while interacting with clients.

No matter what technological advances come along, providers need to be mindful of the most powerful tools: our eyes, our ears and especially our hands.  We need to use these senses, but also remember to trust them as much, if not more, than our gadgets. 

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