Are we too dependent on technology in the field of medicine? There seems to be a test or radiographic procedure for everything we do as clinicians. While this is important to the advancement of medicine, we should not forget how reliable our very own clinical skills are.
As clinicians, we have to make sure that our continually increasing choice of various testing options does not start separating us from our patients. The use of technology should be seen as a supplement to the clinical skills that we have worked so hard to attain. If we listen to the patient carefully enough, the history itself will help lead us down the path toward the correct diagnosis.
The advent of CT scans has been exciting in that this imaging technique has allowed us to detect and treat effectively a number of diseases. But some might argue that we’re relying too heavily on this technology. In their 2007 review article in The New England Journal of Medicine (357:2277-2284), David J. Brenner, PhD, DSc, and Eric J. Hall, DPhil, DSc, cited data that put the number of CT scans ordered per year at an estimated 62 million, with 4 million of those tests done in children. I believe that by taking more detailed patient histories and conducting thorough physical exams, we could reduce the number of CT scans ordered, thereby decreasing our patients’ exposure to radiation and saving money.
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Technology is becoming more prevalent in the use of electronic medical records (EMRs). This is a positive step for several reasons, one of which is accessibility: Our practice has multiple office locations, but we are able to access all of our charts from any of our sites or even from the outside when we’re on call.
Another advantage of EMR systems is that prescriptions are printed out or are e-prescribed, reducing medication errors and the potential for drug-drug interactions.
Nevertheless, EMRs can bring a negative aspect into medicine if not used correctly. The provider has to be careful not to focus all of his or her attention on the computer rather than the patient. My own relatives have described clinical appointments during which they felt the computer took away from the provider-patient relationship; they did not feel that they had the provider’s full attention. One way to avoid this pitfall is to position the computer screen so that the provider faces the patient and can make eye contact.
The provider has to remember that the computer is a tool for helping the patient, but it should not be the focus of the patient’s visit. With the integration of technology into medicine, we can make great strides, but we must be careful not to depersonalize medicine for our patients.
The stethoscope was invented around 1816 and has evolved into the many different and expensive models available today. Yet my supervising physician often reminds us he was taught in medical school that the brand of stethoscope hanging from your ears doesn’t matter; what matters is what’s between those ears.
Let’s focus on taking time to listen to our patients and relying on our clinical skills. We should not be afraid to utilize all the advances in medical technology we are so fortunate to have, but we must not depend on this technology so much that it overshadows our first line of diagnostic testing: our clinical skills. As Elisabeth Kübler-Ross, MD, said, “We have to ask ourselves whether medicine is to remain a humanitarian and respected profession or a new depersonalized science in the service of prolonging life rather than diminishing human suffering.”
