Video Transcript… Lightly edited:
Healthcare and Social Media: The Orthopedic Minute
Good morning, I am Howard Luks. News Flash: Healthcare Technology is advancing at an incredibly rapid space… imagine that !
As a physician it’s hard not to notice. Not only in terms of devices and manufacturing, but in terms of the cloud, the computer, social media, our ability to communicate— these are all enabling healthcare technologies that could enable or allow us to diagnose and potentially its treat.
Where can this go wrong or where has it gone wrong. As I have heard quoted recently by a physician on the West Coast giving a talk on TED. “I guarantee you that if a patient enters my institution today with an amputation on a limb, many physician wouldn’t believe it unless a CAT Scan or an MRI was obtained to confirm it”.
I am not sure that was a joke, I am not sure that that’s the way that healthcare isn’t being practiced quite widely across our country.
The art of the physical examination, the art of the interaction between a patient and a physician is being lost. Is it because of technology? Perhaps, a little. Is it because of other issues — such as time constraints, decrease in reimbursements, heightened risk aversion due to fear and malpractice — yes. I think all of those variables enter into the equation. However, we as physicians must recognize the changes that are taking place and we must realize what our role or position is — and we must learn how to incorporate that technology — to benefit you the patient as well as us, the physicians. Technology cannot supplant or replace that relationship that exist between a patient and a physician. That relationship that is based upon us listening to you, us trying to work with you to get more information from you about the reason why you are in your office. We then need to actually perform a physical examination, they don’t make an iPhone app to that — and if they do— its not going to do the same job as the two hands that I was born with.
Taking into account patient’s history, their physical examination, their complaints and then their x-ray or MRI findings creates a story. Then you delve deeply into what type of effects the issues are having on your quality of life. And then you complete the story by determining the personality of that injury or how that issue in particular issue is effecting you — and then we review the personalized choices and discuss what you believe you want to do about it.
So healthcare technology has a role, I think that role is limited, I think that role is over utilized and over prescribed. Right now I think we need to head back to the basics. The art of a physical examination and a physician-patient encounter — and in the end we will all be better because of it, have a great day.
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Dear Readers,
I am a radiologist, and I wholeheartedly agree with Dr. Luks.
There are so many situations in which imaging is overutilized. In many ways, younger physicians and physicians in training are growing dependent on imaging to aid and confirm diagnoses.
Many referring physicians will refuse to see patients until advanced imaging is performed. For example, in the ER setting when a patient presents with abdominal pain, the general surgeon will often not perform his or her consult until a CT scan of the abdomen and pelvis is completed.
There are many things that need to be considered:
1. Radiation dose.
2. Delay in physician evaluation
3. Cost to the patient
4. Cost to the healthcare system
5. Potential delay to the patient that actually needs to be imaged and evaluated by the radiologist
I am sure there are other considerations, this is just a start.
Dr. Luks, thanks for another excellent blog and a reminder to return to basics!
Best regards,
Dr. Brian Sabb
http://www.linkedin.com/in/briansabb
Brian, Thank you very much for your kind and supportive comments !
Howard
I Could not agree more with Dr Luks here. Technology was supposed to drive quality and efficiency so that doctors could have more focus, time and interaction with patients, not less.
So true Clint… and your platform will help facilitate that interaction! thx for stopping by!
Howard