Science marches on. Every day there are announcements of advances in areas which impact health care. Advances are made in genetics and DNA testing. Computers are being programmed to do more and more. New medicines are being developed. New applications are being found for old medicines. A recent story in the Wall Street Journal described a screening tool developed by a doctor which works with electronic medical records. As a physician caring for a patient enters information into the electronic record, the computer screen displays questions related to the potential diseases the patient may have. By asking the questions and recording the answers, the treating doctor triggers the computer program to estimate the chances that the patient has a particular disease. By assessing those chances the treating physician can better direct his or her care, avoid ordering tests which may be unnecessary and also avoid prescribing antibiotics or other medications which may also be unnecessary. According to the story, tests of the computer program have shown that doctors using it for patients suspected of having strep throat were able to reduce by 25% the number of prescriptions they wrote for antibiotics just in case the patient had strep.
This kind of program is exactly what we should hope doctors use when they care for us. The program takes advantage of medical knowledge and aids in decision making. Importantly, it does not prevent doctors from ignoring its recommendations and digging deeper, if they feel the need to do so.
So what is the problem? The problem is the usual one when new technology comes on the scene or even old technology that involves doing things differently than before. Some doctors huff and puff that no machine is going to tell them how to practice medicine. Some doctors do not want to give up the income which they receive for ordering and interpreting tests that their patients may not need. Some doctors are just too set in their ways to accept changes, even changes that can improve their patient care and save money for their patients and the health care system in general.
As I see all too often in my practice, doctors are only human and as humans we all make mistakes. We should all be humble enough to accept help from any source which makes it less likely that we will make mistakes, which has the potential to improve the way we do our jobs and which can save money. If it were only that easy.
