Health care and society at large are in the midst of “a technological revolution with human connection,” and while that holds promise, if we aren’t careful and intentional, personal and doctor-patient relationships will get lost amid the advancements, Abraham Verghese, a physician, professor and author, told attendees at Day 2 of AHIP 2024 on Wednesday.
Verghese, whose keynote address sometimes had hints of a college lecture, said the AI age in health care is “as profound as the discovery of antibiotics.” There is so much more data available about patients than ever before, but that information often “eclipses” the patient, Verghese said.
Rather than visiting patients at their bedside, Verghese said, clinicians often are in conference rooms poring over patient data. “Even though the data is valuable and necessary and adds to our insight about the patients, it’s taking us away from being with the patient,” which can lead to several consequences.
Patient dissatisfaction is one of them. Clinicians typically spend at least half their time looking at a screen while seeing a patient, which makes it “very difficult to give them the sense that you were being attentive,” Verghese said.
Verghese, who teaches at the Stanford University School of Medicine, practices medicine and is a New York Times-bestselling author, cited an article he wrote in 2008 for the New England Journal of Medicine in which he posited that patients have become icons of sorts, while icons – i.e., clinicians’ computers – have replaced patients.
“And that entity in the computer, which I call the ‘iPatient,’ is getting wonderful care across America,” Verghese said. “But the real patient in the bed often wonders, ‘Where is everyone? Are they going to come and tell me what’s going on? How long am I going to be here?’”
This dynamic is a catalyst for burnout, Verghese said. Clinicians spend at least the same amount of time visiting with patients as they do inputting data, and often more. “We have become the most highly paid clerical workers in the hospital,” Vanghese said. This imbalance is causing many early-career clinicians to leave the profession. “It is endlessly challenging, and lots of young physicians I know are just dropping out. They just don’t see this as attractive.”
The constant distraction of technology also can lead to medical errors, Vanghese said. “We make the most obvious kinds of mistakes when we don’t listen to the story or when we don’t examine the patients and find the most obvious things.”
The end result of these consequences could be the reinforcement of negative perceptions about clinicians. “When we don’t examine patients, and we don’t spend time with them, and we just sort of breeze in, talk about the data and walk out, we become almost a metaphor of how we are viewed in the health care system,” Vanghese said.
“The system has to care”
Striking a balance between technological advances and maintaining human connection is a major – and critical – challenge for health care, Vanghese said. Attentiveness to data won’t accomplish that. “The system has to care and express care,” Vanghese said.
Telehealth is one tool that might help clinicians better connect the dots with patients. When telehealth use spiked during the COVID-19 pandemic, Vanghese was initially skeptical. “It’s bad enough we’re not examining people already, and now we’re going to try and do this by computer.” Vanghese found that the technology gave clinicians a window into patients’ lives.
“I was blown away because very often it was the first time we were actually looking into the patient’s homes and realizing that there was this whole family crowded into this one room, or that this dog is a profoundly important thing to this patient, or that this patient is parked outside Holiday Inn because they have no Wi-Fi,” Vanghese said.
Technological advancements will change health care and how clinicians practice medicine. But in Vanghese’s eyes, the most effective health care innovation will factor in the human connection.
“We’re dealing with people at the time of their greatest distress,” Vanghese said. “And that is the place where I think innovation has to come.”
Keeping the balance between technology and human touch – and how it relates to patients – top of mind is critical for everyone in the health care continuum.
“Each man and woman is ill in his or her own way,” Vanghese said. “There’s a tremendous need for patients to feel that this is a relational transaction, that this is not just a pure transactional relationship, but this is a human relationship. It’s a personal and an intimate one.”
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