The AMDIS Connection: Hiding Behind Health IT? Not Quite
A recent blog in The New York Times online stated that modern healthcare delivery is becoming ever more dependent on computers, with "bedside medicine" evolving into "desktop medicine."
The statement about a transition from bedside to computer-side medicine merits a comment. The thing that clinicians want to replace isn't time with patients, and we're not using health IT as a shield. We do want to replace the notion that physicians are focused on generating more money and more free time away from patient care. The correlative and equally damaging fallacy is that younger physicians want more time away from patients because this new generation doesn't have a caring attitude.
The vast majority of physicians at every age want to have more time to have that communication with patients. One of the most important intangibles in medicine is the human contact. It always has been. Yes, some physicians want to make loads of money and there are self-serving, selfish people in any profession. But I think the group coming up has a realistic outlook in terms of absolute remuneration, even those pursuing specialty careers.
It does a disservice to assume that younger physicians, in particular, want to get away from the bedside because they lack a caring attitude. If you're pursuing medicine as a career, the things that make it worthwhile are the looks in the eyes of the patient and the family and the relationships you build. I know that sounds a bit romantic and it might not seem evident in a busy emergency room where no relationships are forged. But still, there is always that opportunity for feedback in the practice of medicine, whether it's on the battlefield or in an ER or the ICU or in a doctor's office. And that feedback is human.
The defeatist attitude toward health IT might be promulgated by those who don't understand what these tools can do—simplify (or at least navigate) byzantine compliance, billing and, in some cases, documentation rules. The notion that these computer tools are in fact going to switch the bedside to the desktop side is, I think, a smokescreen, and we need to call that out.
The major issue with this is that the people who could be hurt the most by that kind of assumption are the ones for whom this is a calling. We need to clearly differentiate not only what IT should do but what we should insist these tools do, way beyond the idea of dismissing all products because one didn't work. If our profession remains disengaged from this kind of dialogue with technologists and others that don't really understand that, then we're going to get what you'd expect.
Our responsibility is to dispassionately pick up health IT, evaluate and give feedback. If a system is egregiously bad, we should refuse to use it until it improves. There are successful implementations in terms of clinician adoption with almost every major brand of EHR. To me, that means there is probably far more potential than people seek in the software.
The fundamental truths haven't changed in over 40 years. What I think is changing is there's so much buzz about IT that we're seeing all manners of different statements—some of which are sage and ring true, other that are inflammatory and self-serving.
When the younger doctors want to stand up and say "this part of outpatient documentation just doesn't work right," defend them. Help them out, because disengaging, letting the younger generation "just deal with it" instead of supporting them goes against what we all learned in med school. We looked to senior physicians on faculty and on staffs in hospitals as our teachers. Now, as senior staff, we can't abandon the younger generation. Read up, talk to some colleagues, then get back and engage.
The statement about a transition from bedside to computer-side medicine merits a comment. The thing that clinicians want to replace isn't time with patients, and we're not using health IT as a shield. We do want to replace the notion that physicians are focused on generating more money and more free time away from patient care. The correlative and equally damaging fallacy is that younger physicians want more time away from patients because this new generation doesn't have a caring attitude.
The vast majority of physicians at every age want to have more time to have that communication with patients. One of the most important intangibles in medicine is the human contact. It always has been. Yes, some physicians want to make loads of money and there are self-serving, selfish people in any profession. But I think the group coming up has a realistic outlook in terms of absolute remuneration, even those pursuing specialty careers.
It does a disservice to assume that younger physicians, in particular, want to get away from the bedside because they lack a caring attitude. If you're pursuing medicine as a career, the things that make it worthwhile are the looks in the eyes of the patient and the family and the relationships you build. I know that sounds a bit romantic and it might not seem evident in a busy emergency room where no relationships are forged. But still, there is always that opportunity for feedback in the practice of medicine, whether it's on the battlefield or in an ER or the ICU or in a doctor's office. And that feedback is human.
The defeatist attitude toward health IT might be promulgated by those who don't understand what these tools can do—simplify (or at least navigate) byzantine compliance, billing and, in some cases, documentation rules. The notion that these computer tools are in fact going to switch the bedside to the desktop side is, I think, a smokescreen, and we need to call that out.
The major issue with this is that the people who could be hurt the most by that kind of assumption are the ones for whom this is a calling. We need to clearly differentiate not only what IT should do but what we should insist these tools do, way beyond the idea of dismissing all products because one didn't work. If our profession remains disengaged from this kind of dialogue with technologists and others that don't really understand that, then we're going to get what you'd expect.
Our responsibility is to dispassionately pick up health IT, evaluate and give feedback. If a system is egregiously bad, we should refuse to use it until it improves. There are successful implementations in terms of clinician adoption with almost every major brand of EHR. To me, that means there is probably far more potential than people seek in the software.
The fundamental truths haven't changed in over 40 years. What I think is changing is there's so much buzz about IT that we're seeing all manners of different statements—some of which are sage and ring true, other that are inflammatory and self-serving.
When the younger doctors want to stand up and say "this part of outpatient documentation just doesn't work right," defend them. Help them out, because disengaging, letting the younger generation "just deal with it" instead of supporting them goes against what we all learned in med school. We looked to senior physicians on faculty and on staffs in hospitals as our teachers. Now, as senior staff, we can't abandon the younger generation. Read up, talk to some colleagues, then get back and engage.