I was surprised at responses to my last article about the new way of practicing medicine. Some postings sought to defend doctors, but I wasn't attacking them; and some comments were that I was belittling the value of computer-use in medicine, which I didn't intend to do. My point was about doctors not listening enough and relying too much on statistical data. Some of this is because they're overworked, as I said, and some because of how they're now trained, but none of that removes the ethical obligation to listen.
In Larry Niven's sci-fi stories, "autodocs" take care of people. You climb into a programmed high-tech box and it fixes whatever's wrong. We won't see that for a while, but we're seeing greater reliance on computerized diagnosis, and it's going too far in various ways. Probably we should prepare, then, to hear comments like: "I feel fine but the computer says I'm sick"; or worse: "I feel sick but the computer says I'm fine."
There's no question we should avail ourselves of available technology in health-care. The question is how it's done. We've got to remember we aren't just bodies. It's one thing to take an ailing car into a diagnostic center; it's quite another for an ailing person to go to a doctor. People who aren't well need to be heard, not just to be diagnosed. Nor is this a matter of psychology or even kindness; a patient just might provide information that alters a diagnosis based on averages--for instance, spinal stenosis has no readily measurable indicators. It's also important for a doctor to understand what patients can cope with.
But more than this, being a doctor is not just being a mechanic. Some surgeons and specialists can get away with that, seeing their patients as "the ruptured spleen in 238" or whatever, but most specialists and certainly general practitioners have to listen. Of course, as a doctor friend tells me, often patients talk too much and about all the wrong things. Patients also fail to listen, especially when asked questions.
There are problems on both sides, sure; but it won't help if the effort isn't even made. My last article and this one have to do with that effort. In too many cases it's just not being made. There are lots of reasons and excuses for it not being made. I don't think any are good enough.
