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They say the Internet has revolutionised the way the world is doing business and undergoing education. That’s true in medicine as well – gone are the days that medical students cut up human cadavers and lug around Gray’s Anatomy. The use of virtual 3D models and optical discs has made studying medicine a bit more bearable; but even these technologies will fall by the wayside in the future.
A recent study Taking The Pulse v9.0 issued by Manhattan Research found that 64% of doctors, more than double the number eight years ago, are using smartphones — iPhones, BlackBerrys, Treos and other hand-held devices.
How can smartphones help? Some examples:
- A doctor seeing a patient for the first time can be astounded by the variety of pills given by previous doctors. By feeding in the shape, colour and probable use of the pill into a software called Epocrates, one is able to obtain a list of medications and images that match those criteria, allowing the doctor to identify the pill.
- While dining in a restaurant, a doctor can receive an attachment by email showing an ECG done by a colleague of a patient about to get a heart attack. Previously, he would have had to stay at home and wait by the fax machine.
- By the bedside, a doctor can check immediately the dosages of medicines, drug interactions and even show images to help the patient understand better.
Such is the popularity of these devices that some medical schools, like Georgetown University in Washington DC already require their students to each use a smartphone. This is a trend catching on fast and it looks like a matter of time before they are used in all med schools.
But with any new technology, there are reservations. Take privacy concerns, for example..all this patient stuff in a smartphone can fall into the wrong hands and create confidentiality issues. There are concerns too by some patients that it would be quite annoying talking to a doctor who’s busy peering into the small screen and apparently not paying attention to what is being said!
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With the plethora of diagnostic devices and computer-generated devices, its not surprising that some doctors can arrive at a diagnosis without coming into physical contact with a patient, other than by entering the room with a cursory greeting and a customary “how are you?”.
Physical contact includes simple things like hand-to-hand contact and actual physical examination of the patient. True, there are limitations as to what can be achieved by using your five senses, what with high-fangled scans and sophisticated devices being able to get to the root of the problem with hardly any sweat being raised.
My contention is that the physical examination is an important ritual in establishing a good patient-doctor relationship. This ritual sets the stage by which the person being examined transforms his role to that of a patient and also, places his trust in the hands of the doctor examining him.
And just in case you think rituals are not important, we might as well have not had the Presidential swearing-in ceremony for heads of state!
“To cure sometimes, to relieve often, to comfort always”
-ascribed to Hippocrates (Greek physician, 460-370 BC)
As a medical student this message would have been drummed in countless times; and, as a young doctor, one will realise that permanent eradication of illness is not always possible and that many diseases cannot be cured. One needs to not just administer pain-killers but also to devote time to understand the patient’s agenda despite a busy work schedule, offer empathy and, most important, seeing the patient as a human being, not just an object to operate on or to inject drugs in.
When treatment has failed to cure and patients are about to die, many doctors and nurses feel they have failed and give up their hands in despair. Don’t forget that that the dying patient still requires another form of treatment – palliative care.