When I first started in emergency medicine, computers were rarely used. If I needed to look up a disease or a new treatment, I would often check out a textbook. Unfortunately, by the time the textbook is published, many of the treatments are already out of date. I would also contact a medical librarian, who after a few days could send me the articles which I requested. Real time searches for issues which could help patients whom I was seeing in the emergency room was simply out of the question. Another option was to call a specialist, who between seeing patients and doing procedures could at times get back to me and help me out with a difficult case.
Fast forward to today, where in seconds I can have access to virtually the entire world’s medical literature, specialists galore and other physicians who have encountered similar medical dilemmas. Awesome technology at my doorstep! In fact with apps, I can use my IPhone to search the medical literature, listen to patient’s hearts and even use the phone as a quasi ultrasound to help diagnose some conditions.
Yes, I was dragged kicking and screaming into the digital age. At first learning how to send an attachment was for me mind boggling. Learning the language is still an ongoing project. What I miss however are the real world interactions with patients and with colleagues.
Nowadays I spend more and more time clicking-whether it be to access patient charts, order labs and or treatments, search the medical literature or email/text colleagues. This leaves less time for face to face contact with others including doctors, nurses and patients.
Recently, I had a physical. My doctor sat behind a computer attached to a portable stand with wheels. He asked me questions, clicked a few times and sometimes showed his face. After a brief exam, he again returned his cubby hole and in between more clicks talked to me about my exam. When it was over, I received an impressive computer generated folder about his findings. If I needed to get a hold of him for any reason, I could simply email him and he would return the favor with another email.
Without a doubt computers have allowed clinicians unprecedented access to medical literature and patient’s charts. What we have gained at our fingertips, we are sadly losing with real time human interactions. One solution which many ER groups are trying is to hire medical scribes to do much of the computer work, leaving time for the doctors to actually talk with patients. Healing comes not only from treatments but also from empathy, from a gentle touch, from a kind look, from listening, things which simply cannot be conveyed via computers.