Dr. Jeff Kane: Are doctors a threatened species?
You’ve probably seen the 1929 painting by Norman Rockwell, “Doctor and the Doll.” It depicts an old country doc listening with his stethoscope to the heart of a doll held up to him by a worried little girl.
Today we’d call this quaint, a relic of a bygone era. That doc was an independent professional, thus able to take the time to know his patients more personally. Now almost all docs are employees under the direction of businesses. Healthcare has morphed from a service to an extremely profitable industry, leaving physicians with little mandate beyond barebones diagnosis and treatment.
Omitting time to attend to patients’ quite relevant relationships, emotions, and perspectives, current healthcare reduces the patient to an entity simply in need of physical tweaking, and the doctor to a technician. We know patients and doctors are more than that, yet both parties generally accept this spare view of healthcare as a given. Medical students receive ridiculously little training, if any, in patients as whole persons, as though that subject is, well, quaint.
Diagnosis and treatment aren’t a terrible goal, of course. But if that’s the way we continue to limit medical practice, it’s going to go the way of the passenger pigeon, since we now have machines that diagnose and dictate treatment, and do it better than docs.
When I was in training, for example, we’d learn the oxygen content of a patient’s blood by locating the femoral artery, plunging a needle into it, drawing off some blood, and then waiting forever for the lab report. Now we just clamp a tiny device onto the patient’s finger and it delivers an immediate, accurate result.
These methods are advancing at an astonishing pace. Portable devices now in use rapidly record vital signs while testing for a wide variety of illnesses. Computers are already more accurate than doctors at diagnosing cancer and some other diseases.
If you ran a healthcare company, would you rather pay doctors handsome salaries and put up with their quirkiness and inevitable errors, or would you replace them with hardware and software that’s more accurate, never complains, and in the long run is far cheaper?
When that scenario inevitably arrives what will be left for doctors to do? Some superspecialists will never be replaced by machines, but most docs will discover that they’ve been demoted to sophisticated gadget jockeys, hardly relating to patients at all — maybe even working remotely, miles away from them.
But there’s one thing doctors used to do — and still can do — that machines will never match, and that is to listen to that doll’s heart. They can revive their venerable mission of comforting, educating and guiding patients. No machine can do that.
Just as alternate career training is now available to some workers in dying industries like coal mining, education in human contact should be made available to today’s physicians. Right now, that training is rare and rudimentary. For our own well-being, let’s encourage it.
Jeff Kane is a physician and writer in Nevada City.
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