Please answer the questions below by class time on Wednesday, June 1st.
- What stood out for you in this chapter?
- At the end of chapter 9, Dr. Sanders had mentioned implementing a "checklist system." After reading chapter 10, do you think computerized diagnostics or implementing checklists would have a more positive impact on patients in the next 5 years? What about in the next 30 years? Do these tools address the same issues, and if not, what key issue are they still missing?
What stood out to me in this chapter is that woman's Google search on rocky mountain spotted fever. I'm surprised that she had the initiative to even look into her diagnosis when her doctor already ordered multiple tests and somewhat made a diagnosis. I'm also surprised her doctor took her advice! After all, she's just the patient.
ReplyDeleteThe checklist system could help doctors make more routine checkups by providing a list of things to check every visit. However, I think doctors already do this sort of thing, if not written out, then inside their heads. In terms of computerized diagnostics, I believe there is still much to be developed to make it a truly viable go-to equipment for doctors. These computers only provide lists for the doctors to run their ideas through, and do not make logical decisions for the doctors themselves. These computers so far are just medical Googles. Surely, it'll get much better in the future, but as of now, I dont see a way for doctors to incorporate them into daily checkups.
What surprised me most about this chapter was the unwillingness of many doctors to utilize programs like Isabel. i think it's almost irresponsible to not utilize these systems to ensure that you've made the right diagnosis, and to find a diagnosis when you can't decide yourself.
ReplyDeleteThe checklist system of which she speaks doesn't seem feasible in the next five years, because it will require most or all of a patients medical information to be online and accessible by any doctor, and would be very expensive. However, these tool do not address the issue of incorrect diagnosis, which is also a significant issue
What stood out for me in Chapter 10 were the limitations of computerized diagnostics, as they exist right now, in improving the process of medical diagnosis. While the technology for using computers for diagnosis is clearly improving, they depend on a doctor's willingness to accept digital help and continue questioning their thought process even after they have arrived at a possible diagnosis. It seemed to me like the Isabel computer diagnostic system probably wouldn't have helped diagnose Isabel Maude's chicken pox complications, simply because the chicken pox diagnosis was so apparent to the doctors that it wouldn't have occurred to them to pursue further inquiries. In order for a computer diagnosis system to be broadly helpful, it would, as Dr. Sanders stated, need to work in the background and give doctors no choice but to use it.
ReplyDeleteI think the "checklist system" would have more of an immediate positive impact on patients than computerized diagnostics. Based on the data in Chapter 9, it seems clear that preoperative checklists would greatly reduce surgical complications. It also seems like a checklist system would be relatively easily accepted by doctors, since it wouldn't require a great change in how they do their work. As I said before, it seems like a computer diagnostic system would need to be better integrated and work in the background before it would have a broad impact. The two tools address different issues; the checklist system is aimed at preventing errors during medical procedures, while computer diagnostics are aimed at making sure that doctors do not make mistaken diagnoses. The issue of mistaken diagnosis seems much more complex than that of surgical error, as it is more related to the thought process of the doctor, which is more difficult to change than a surgical procedure is.
What intrigues me is that, in its current state, computerized diagnostic programs are still not in any shape to serve as anything more than a tool for physicians to double-check their diagnoses. Programs like GIDEON and Isabel do their job well acting as vast databases to help doctors look up small details (like the typical geographic location of and recommended treatment for strongyloides), but their function remains largely that of an encyclopedia. When doctors use Isabel by punching in their key findings, the program shows the correct diagnosis among a list of other possible candidates around 96% of the time. However, inputting whole-text entries yields the appearance of the correct diagnosis only 76% of the time. This is one of the key reasons as to why the use of computerized diagnostics is still not prevalent today – they are not accurate enough, and are tedious and time-consuming to use. The implementation of checklists and/or computerized diagnostics (in their ideal form or not) has and will continue to have a greatly beneficial impact on patients for years to come. However, GIDEON and Isabel are only as useful as their doctors and the information they input. Eta Berner is correct in stating that the ideal diagnostics program would work with the doctor, catching his mistakes or prompting him to order an extra test. Ultimately, the question that remains is if or when we'll reach the level of medical technology that Szolovits originally imagined.
ReplyDeleteWhat surprised me about this chapter is the hesitation from doctors to use programs like GIDEON and Isabel. I think that computers can be really useful to doctors if they utilize them in the right way. I also think that computers are kind of a cop out for a lot of doctors, or they could become one. I think that computers will start taking the job of many doctors and even though Dr. Sanders is obsessed with the physical exam, I think that she fails to see the future in computers. Even now, patients are using things like WebMD instead of going to the doctor. This can be both useful and harmful. I will always think that computers are awesome resources, but they will never be a substitute for a doctor or a physical examination.
ReplyDeleteI think that the checklist system could be very useful to doctors. I also think that it might force them to take a better look at the patient. The checklist system seems easy enough to do and it wouldn't change the way doctors are working. I'm not really sure about the long term impact, but I am sure there is absolutely no harm in starting it.
In this chapter, I was pretty surprised by how many people spend huge amounts of time and effort into creating databases that solves medical mysteries. Szolovits, Dr. Bia, and Maude all have this dream of integrating technology with medicine. I was most surprised by the effort put into this project by Maude after his daughter, Isabel, was misdiagnosed. I am surprised not by his energy, but the direction he put it in. Although I think these ideas are pretty cool, I have plenty of doubts. Humanity has always sought “technological goddesses” in order to save time, effort, and money. I can’t help thinking that this is yet another dream of a short cut that goes too far. Technology cannot (at least not yet) make intelligent decisions based off constantly varying information (like symptoms).
ReplyDeleteThe idea of a “checklist system” brings up a very important point. I feel that doctors can use the ever-growing role of technology as a preventative measure, not as a holy grail. Sanders showed how one twenty-one-year-old patient Googled her disease as a result of one of the rare possibilities suggested by her doctor (the doctor mentioned the “Rocky” fever when he was figuratively running the gamut of her symptoms) Sanders made the point that computers (obviously) can contain more accessible information than humans. We should use this, not computers lacking analytical ability, to aid us. I see very little improvements in the next 5 years. There simply isn’t enough time to reconcile the difficulties in connecting the technological world with the extensively varying symptoms humans have. However, I am optimistic about technologies role in the next 30 years. Perhaps doctors won’t just assume they’ve solved a case because they stumble upon a typical presentation of a typical disease. Maybe doctors can “check themselves before they wreck themselves" with the application of universal databases that help filter gigantic amounts of information.
In this chapter, I found the discussion about Szolovits' initial idea to turn diagnosis into a computer-intensive idea very interesting. At first, it seemed perfectly logical to me. If doctors are searching for what disease can cause a specific set of symptoms, why not simply enter the symptoms into a computer, that would then go through more data than a human brain could ever hold, to match the set of symptoms to a disease? Moreover, much of the time it seems like the set of symptoms a patient has matches the set of symptoms typical to a disease rather well; wouldn't a computer work well to help doctors connect symptoms with diseases they might not have thought of? Although I understand the logistical issues behind this, in terms of putting a set value or name to a symptom, I do think it is an interesting idea, that I personally haven't completely dismissed as a possibility.
ReplyDeleteI think the main obstacle to implementing a checklist system in diagnostics is, as Dryden mentioned, the infinite degrees of variation a symptom can have. A certain symptom can be placed under one name, yet there can be a myriad of different manifestations. As I mentioned, I do think that this is a possible direction the medical/technological integration process could take, yet we would need to find a way to reconcile what a human is able to perceive and what a computer is able to "understand" through a checklist. Technology would have to advance to the levels of having artificial intelligence that has at least some of the human powers of perception, and the ability to distinguish between minute differences. I believe this technology isn't something that is going to come about soon, because no matter how smart computers are, the ability of humans to perceive subtle differences that we can't quite put a finger on is unique.
What stood out to me in this chapter is the disfunctionality of many of these diagnostic programs. What doctors/ website designers need to work on making a more user-friendly program. The major issue with programs right now is that they are extremely time consuming for the doctor to use. What needs to be done is the development of integrating doctors routine note taking to be integrated into a program that tracks notes, possible diagnosis, and the correct diagnosis. If a program could successfully record and understand data through the scanning or some other method of note taking that would then go into a database, then doctors would use the program more and have more successful diagnosis.
ReplyDeleteI think that in the years to come digital diagnoses will become more popular and more common. However, unless new advances in ease and functionality in programs, the advancement of digital diagnoses will stagnate.
Dan Cohen period 4
ReplyDeleteWhat stood out to me the most in this chapter was how much time Dr. Sanders devoted to discussing the application and use of Google in modern medical practices. I almost thought she was just going to write it off as being too built for a mass audience or not specific enough but I thought Google's usage as a diagnosis machine was intriguing.
I believe that the checklist system talked about EPTAS is an interesting idea. However, I believe that doctors already do something that is similar in their heads. That being said, a checklist that is computer-aided could be very helpful. The entire point of the computer aided diagnosis machines (at least the modern ones) is to narrow down the possibilities of a diagnosis. In this regard they are very useful. However machines that diagnose patients by themselves are 30 or more years away (AI).
What surprised me in this chapter was actually the ease with which so many doctors (and the author herself) could accept the idea of technology being integrated in the diagnostic process. After so many chapters about how diagnosis is medical art, it was almost a letdown to now read that computers are getting closer to becoming diagnosis-machines. Certainly part of my reaction is a sentimental view of medicine, and cynicism towards digitalization in general. But I think there's some legitimacy in my concern. Yes, good doctors will utilize programs like GIDEON, Isabel, or a vamped Google program primarily to double-check their diagnoses or to help with mysterious cases. But having this technology will make bad/mediocre doctors even lazier and worse at diagnosing patients. I think there's definitely a place for technology in medicine, but I can't help but be concerned that the "reasonableness" of current diagnostic technology could be lost.
ReplyDeleteAs for a checklist, I think don't think it's unrealistic to hope for effective diagnostic checklists within 5 years, but it's safe to bet they'll be much better in 30 years. I think it'd be helpful for doctors to have a simple checklist of things to look for when diagnosing patients, especially in situations like public clinics where they are extremely busy. This could be a helpful supplement for doctors, but again, I feel very strongly that technology should never become a replacement for complex human thought processes.
I was particularly surprised by the crude nature of many of the computerized diagnostic tools available today. Computers seem to give so much to today's society, yet somehow the diagnostic programs we currently have are very basic. Indeed the statistics for the programs were incredibly low, to the point that I began to doubt whether or not they would be able to be improved to the point of being efficient and useful. I agreed with Szolovits that there should be some way to create an infinite knowledge base for doctors though computers, but after reading the chapter it seems that this idea is too fraught with complications to work. Indeed for the most part the largest obstacles are purely technical - doctors not wanting to input data, search engines being inefficient, a simple lack of a market.
ReplyDeleteI think that a checklist could be in development within the next five years, but that it is far more likely to be complete and useful in 30 years. There are simply so man technical details that must be worked out before these systems can be used. Also, a shift in mindset must occur in doctors so that they recognize the importance of a checklist and take the time to be sure not to close a case too early. Yet a checklist, or even a diagnostic program, can never stand in for a true doctor in my opinion. These tools can be helpful in diagnosis, and can aid in the prevention of mistakes, but human intuition is necessary in most cases to provide an accurate diagnosis, especially one that will lead to productive results for a patient.
I was surprised that current computers had such glaring gaps/flaws in diagnosing patients. I would think that by now, we would have developed much more accurate programs to help with diagnosis. On the other hand, computers are not alive, so they will never completely be able to perform all the intricate actions humans perform such as sensing or critically thinking. Some of the programs seem to be advanced for their era such as DXplain, GIDEON, and Isabel, but there are still unavoidable problems with using them widely in the medical field. GIDEON seems like an especially interesting and helpful program because as we have seen in reading this book, many of the cases that go misdiagnosed are the result of the rarity of the disease or the foreignness of it. Using the help of GIDEON, doctors can consider various diagnoses that he or she would not usually encounter. The story about the woman who self-diagnosed after browsing around on Google was a little frightening because her health could have been majorly damaged, but it also provides hope for the reduction of error especially due to doctors’ premature assumptions. Although I know Google has access to an endless amount of information, I was still shocked that the woman was able to figure out what her health issue was.
ReplyDeleteAfter reading chapter 10, I do think that checklists or computerized diagnostics would be helpful in several aspects, raising the overall awareness of doctors. However, I agree with Dr. Sanders that computers will never take over the role of doctors for a variety of reasons. Computers can’t feel, taste, smell, see, or hear really anything, which we as humans can do. Humans have a unique, unparalleled brain structure/system that won’t ever be surpassed or even met by computers. Also, if we take out the doctors, patients will forever lose the interaction between them and doctors. As Dr. Sanders so beautifully sums up, doctor-patient interaction is often necessary for healing, which isn’t guaranteed even after diagnosis. In the next 5 years, I think medical technology will improve slowly but surely, and by 30 years from now I think that technology will be as flawless as it can get. New and improved medical technology will most certainly provide a solid second opinion that doctors can refer to to improve diagnostic accuracy.
In this chapter, Dr Sanders discusses the use of computer to make diagnosis. Although the use of computer diagnostics has not been uniformly successful, it provides a helping hand to doctors making diagnosis. Gideon, for example, improves the diagnosis of unusual cases such as infections acquired overseas. Diagnosis made by computers should not be taken at face value. Like an imaging studies or blood tests, computer diagnosis is a complementary tool to help doctors analyzing cases. Computers could never replace human in medicine. As Dr Sanders points out, computers are good at analyzing data but they are not good in collecting data. Computers are unable to extract information from the patients. Computers cannot tell if a patient is telling the truth or is lying. Computers can make diagnosis and even come up with a treatment plan but they cannot give the tender, loving , care to patients. Nonetheless, I feel that computer technology continues to have positive impact on patient care in years to come. In addition to improving diagnostic accuracy, computers could help in different ways. Computers could play a role in record keeping connecting different hospitals. Computers could check for drug interactions. Finally, computers could make up check lists for admitting and discharging patients.
ReplyDeleteI found that the programs created, such as GIDEON and Isabel, were pretty fascinating. The fact that programs are being created to make diagnosis for doctors and that there are people willing to do this is very fascinating and cool. I find that it really demonstrates how people are trying to take advantage of using computer's perfect accuracy as an assistant to doctor's in coming up with diagnosis. I can see these programs really helping the diagnostic errors being created by doctors. However, i have to say, that i still do find the computers to be a little unreliable. In time, i do see the programs such as these being created with even better accuracy, but for now it seems a little unreliable. I agree that a good possible adjustment to these such programs would be for them to demand more from doctors and make sure that doctors are gathering proper amounts of data and information and that they are properly following the physical exams.
ReplyDeleteI think that the checklist would be a good thing for doctors to have because it could act as a reminder for doctors and could help doctors come up with a quick agenda of what to do when beginning to work with a patient. It could also help avoid careless errors that could potentially cause a misdiagnosis. I do see it potentially having an immediate effect too. I agree with Abby that computerized diagnostics and implementing checklists are addressing two separate things. Though they are both attempting to help reduce misdiagnosis in the long run, one is helping avoid careless and lazy errors, while the other is attempting to prevent misdiagnosis by coming up with its own diagnosis based on the data gathered by the doctors and on how well this data is gathered.
What stood out for me in this chapter was the discussion of the use of google in gaining information of different diagnosis. Personally I use google to confirm the diagnosis given to me by doctors, and to read up on the different side effects of the prescribed medicine. It makes sense however that google would be most helpful in presenting rare manifestations of diseases instead of the general disease because there would be less hits to sift through. After learning about the different attempts at a computerized diagnostic tool, I feel that google would work just as well. There are medical journals on google and people can search for symptoms to match diseases.
ReplyDeleteI don't think that implementing computerized diagnostic tools would be particularly helpful, the rest of the book has discussed the importance of performing precise physical exams and learning how to listen to a patients story. The benefit that could be derived from one of these professional tools could instead just be used occasionally from checking google.
After reading a lot about diagnostic error in chapter 9, I found the first mention of a computer program that could aid in the diagnostic process to be very smart, and it seemed quite practical. Therefore, further discussion about a potential computer program surprised me. After reading chapter 9 and before starting chapter 10, I doubted the human brain’s ability to consistently, accurately diagnose patients. However, the initial discussion in chapter 10 changed my mind about that. Dr. Sanders points out that “humans have a set of diagnostic tools that computers may never equal.” This set of diagnostic tools includes all of the senses and comprehension of the observations made by a person’s senses. She also says “a computer, in contrast, has only words and numbers, typed in by a human, that inadequately represent a living, breathing, and immensely complicated patient.” These statements made the power of the human brain much more apparent to me. Overall, the discussion regarding a computer’s inferiority to a human really stood out to me.
ReplyDeleteI think that the implementing of checklists would have a more positive impact on patients than computerized diagnostics. Checklists are a practical way to prevent the overlooking of certain steps in a patient’s diagnosis and treatment. After reading chapter 10, it seems like a computerized diagnostic system is unlikely to be helpful because the power of technology is limiting compared to human ability. Checklists could be helpful in 5 years, and could be expanded to become even more helpful in 30 years. Computerized diagnostics could not benefit the medical field in 5 years because technology will not have become advanced enough by then. But, it may begin to have a positive impact on patients in the next 30 years, if we can find a way to significantly increase the range of technology available to us. I think that checklists create a tool that helps prevent error in the process of diagnosing or treating a patient. It focuses more on the specific steps taken during these two processes. Computerized diagnostics would focus more on immediately reaching a conclusion, rather than going through the process in which checklists would be used.
What really surprised me in chapter 10 was that computerized diagnostics really don't seem as reliable as they initially seem. In theory, it seems like computer programs could have evolved to a very high degree of accuracy given our current technological knowledge, yet, as has been previously stated, computers have the inherent flaw of being just that - machines. So, although there is certainly room for improvement and development, computers will never be able to match specific human qualities. As Dorothy mentioned, while computers seem foolproof and so reliably systematic, the human senses can never be rivaled in the realm of diagnostics (as we previously read, the senses - primarily touch - are crucial tools in the art of diagnosis).
ReplyDeleteA checklist may be a viable option in the future, but a comprehensive, reliable checklist would take many years to perfect (so, 30 years seems a lot more plausible than 5). Yet, nothing can compare to the patient-doctor relationship, and nothing can ever be 100% accurate in the unpredictable world of medicine. As much as society and technology progresses, diagnostics will never be reduced wholly to computer programs or checklists, as there will always be the rare, mysterious, and unknown cases that can never be accounted for. It seems highly unlikely that there will be a system created that will be able to cover such a vast number of circumstances - medicine really isn't a finite realm, and thus can never be completely brought down to such a systematic level.
what stood out to me in this chapter in the belief that computer diagnostic programs could possibly overrule a doctors diagnosis. i agree with dan in the fact that using these resources and tools could be beneficial in cementing a possible diagnosis and gathering more information but i also think that the personal interaction will forever prevail.
ReplyDeleteI think that while checklists will help provide a more stable and unwavering diagnosis, these computerized programs will never completely preside over the touch and the talk of a doctor. Sandler has made a strong argument for the benefits of a doctors touch and a patients story, so i think that the impersonal aspects of computer diagnosis may be able to burrow into the root of the issue and give good feedback but it will never out date the emotional and physical aspect of the patient doctor relationship.
What surprised me in this chapter was just the basic idea that computers could replace doctors, even if only partially. As a potential patient, I would much rather be examined and diagnosed by a doctor, a real person, than a computer. It seems as though technology is taking over the world right now and though it is undoubtedly useful, it is not always an overall improvement. Throughout this entire book we have seen time and time again that the physical exam a doctor does is vitally important. Yes, it is prone to error, but so are computers now and again. The value of using computers and certain programs to aid diagnosis should be overlooked though. I do think they should be a tool a doctor could use rather than a primary option for diagnosis.
ReplyDeleteIn terms of the checklist, I think it could possible be a good option many, many years from now but in the near future would not be very helpful. For a checklist to be truly reliable and useful it would have to be perfected and cover all bases, which could take a very long time. Perhaps the 30 year mark would show it being more useful, but in the next 5, 10 or even 15 years, I don't think it is an extremely useful tool.
I was intrigued by the push to move all medical information onto the internet and away from the more personal diagnosing process used now. The system that Peter Szolovits hoped to implement included a system where all symptoms and diseases would be stored on computers. Doctors would only need to enter the symptoms their patient was having into the computer, and they would be presented with many different possible diagnoses of what their patient might have. Some issues with this system that many people brought up was that it would be difficult for doctors to enter descriptions of their patients problem in a way that the computer would be able to recognize, and also the cost would be more than any hospital or doctor would want to invest in if the system was not perfect.
ReplyDeleteI think a checklist might limit the options that the doctor is willing to look at and could lead to more incorrect diagnoses. Until it has advanced, I don't think the computer checklist will be significantly more advantageous than the current more personal process of diagnosing patients.
I was very surprised by just how many problems there are facing the computerization of medicine, although I guess all the reasons make sense. Computers aren't made to read all the subtle clues that a sick patient presents. They aren't made to read the situation for themselves; they can only use the data that they are given. With the process of giving the computer the information it needs alone, there are several different things that could go wrong, either because the doctor doesn't put in exactly the right description of the right symptom or because there are some parts of the story that are necessary to make the diagnosis but just can't be put into words.
ReplyDeleteI think that a computer program, or at least a checklist of some sort, will be helpful to doctors in the future because it could remind them to keep considering the case even after they have found a diagnosis that "fits". A computer program that can connect symptoms to possible diseases, like Isabel, could force doctors to see other, maybe better, possibilities for what exactly is going on with their patients. This program might not completely solve the problem of diagnostic error, but I believe it would be very helpful in reducing it if used correctly.
What surprised me in this chapter was the thinking that computers could ever replace doctors. Doctors can teach computers to diagnose diseases that they already know about, and I do think that the large databases of information could prove extremely useful to doctors, especially in terms of rare diseases, but using a computer as a diagnostic tool seems like it would just make doctors lazy about learning. If they used a computer during the exam, such as the example where they assumed a doctor could do a physical exam on a patient and the machine would record their findings and spit out a list of potential diagnoses at the end, doctors would ONLY know how to do the physical exam. They would never take the time to learn about what diseases cause what symptoms, and they could never catch new diseases. One point that the author made early on is that doctors don't pay enough attention to patients, and a health care system in which computers were the primary caretakers would diminish doctor-patient relations even more to the point where doctors simply administered treatment and followed computers. I think that while doctors should probably have online medical databases such as Isabel to confirm tricky diagnoses, these databases should only be used when patients have extremely tricky cases.
ReplyDeleteI don't think, for these reasons, that a computerized diagnostic system would have a positive impact on most individual patients or on the medical industry overall, no matter what timeframe we're looking at. I do think that a checklist would be helpful in a lot of cases, because it would catch errors and keep doctors aware. They could present the same issue; using a computerized diagnostic system could be yet another backup for doctors, but in the end, I do think it would just make doctors lazy about checking their work and being thorough. If they knew they had a computer, they wouldn't be as cautious about treatment or diagnosing, since they knew any errors would be caught, and they would become too reliant on machinery. The physical exam would die even more than Sanders insists it already has. Instead of a computerized backup system, doctors could implement a human backup system- doctors could each review one another's work. It would be extra work for them, but having two doctors review a case would eliminate a lot of human error and be less impersonal than a computerized system.
What stood out to me in this chapter was the one doctor’s use of the database GIDEON and how it helped confirm the diagnosis he made. It didn’t stand out to me because it seemed like a good example of how computers can revolutionize the field of diagnosis; I actually thought it demonstrated how humans can’t be expected to depend on computers to make accurate diagnoses. Yes, the database helped him in making a diagnosis, but the diagnosis still would have been impossible had the doctor not already had previous knowledge and expertise. If he hadn’t had GIDEON he still probably would have arrived at the correct conclusion, so I thought the incident demonstrated how computers can help – but only marginally.
ReplyDeleteI think a computerized diagnosis system will only be useful when computers are “smart” enough to observe with human intelligence and be able to connect the dots as human brains can. So basically, not for a long while. In addition, Sanders herself mentions the impracticality of connecting all practicing doctors/physicians by means of a universal system, so for that reason a checklist system probably wouldn’t work
Something that stood out to me in this chapter was the increasing use of computers for diagnosing, and the flaws that they contained. Though I do see the usefulness of computers in the process of diagnosis, computers can not beat human interaction. Online databases of different symptoms and information is obviously a useful tool for doctor's to use when working with a patient but the in the end, the doctor should use his or her own knowledge and their interactions with the patient to diagnose a problem.
ReplyDeleteOn the checklist, like others have said, I believe it could be a good resource for doctors but that it would only become helpful after years of making sure it is reliable.
I found the discussion of using computers to diagnose patients (of course this was one of the key ideas the chapter focused on). To be honest, the prospect of having computers be used as diagnostic instruments is slightly frightening to me. As Dr. Sanders discusses and admits, computers work entirely by math and operate under a strict set of rules and laws. Nature does not work this way. A computer simply cannot be used to complete something as intricate as a diagnosis. This is why I believe our medical computer programs are mainly used as encyclopedias and banks of knowledge. While it is true that a doctor shouldn't flat out reject computational diagnostics, he shouldn't let himself submit to the "wisdom" of a computer. There's something about the human touch and the human connection that goes a long way in doctor-patient relationships. The other scary part of computer technology in the medical field is the prospect of data theft. Computer encryption and data protection is a cat-and-mouse game with hackers. One slip up and all of your medical information could be leaked and grabbed by the wrong hands.
ReplyDeleteThe idea of a checklist is an interesting one. Indeed, I believe there is already something like this in place -- doctors already take notes (or at least the good ones do) and they almost always address these notes in subsequent checkups. The issue with the checklist is a doctor might become dependent on it and fail to look outside the box. This isn't likely to happen but it is possible. A checkup could become merely a list of questions like "is ... better since last time?" and other issues not on this list might go without thought.
What stood out for me in this chapter was the luring possibility that computers can aid doctors by acting as tools in determining diagnoses. Programs like Gideon can help doctors on their path to making an accurate diagnosis but they can’t replace the actual analytical and personal perspective that allows doctors to accurately diagnose their patients. I think a checklist would be helpful both in the short and long run in that it would help doctors catch mistakes and push them towards a more accurate diagnosis but because of its technological nature, it would make doctors reliant and less likely to focus on physical exams, tainting the relationship between doctors and patients that is necessary to make a precise diagnosis.
ReplyDeleteIn this chapter, the frightening example of a patient informing HER DOCTOR of here case of Spotted fever. The doctor had ordered a battery of tests and was planning to send her through the gauntlet, but simple internet usage solved the problem. This is both a compliment to the internet medical community and a jab at the doctor who could not, with technology, a physical aspect, and communication with the patient, correctly diagnose her.
ReplyDeleteI believe that a computerized checklist system for diagnosing patient would be extremely helpful. However, in thirty year, the field of medicine i believe will have advanced so far that we cannot properly predict if something like this will be needed.