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Automated Health Care?

I just read an article in  the most recent Atlantic Monthly about automated health care that I had a really odd reaction to.

By automation I don't mean just streamlining patient information into compatible computerized systems.  The article mentions computers as doctors, middle class labor replacing skilled doctors for exams (and reporting their findings to the previously mentioned computer doctor...), and high tech devices to constantly monitor our health stats.

I say my reaction was odd because I had a series of very different reactions.

One of my first reactions was "cool."  Because people like my Grandma, who strive to be completely med free even after bypass surgery and who tend to prematurely go off of their blood pressure medication, can do so while having their blood pressure monitored not only by self monitoring but also by a medical professional.  And obviously it would be beneficial to have medical records streamlined.  I know most of you are probably shocked by this reaction, but I am neither anti-tech or anti-doctor.  I am just against either of them being used excessively or irresponsibly and without thought and research on the part of the consumer/patient.

Which leads me to my next reaction- "wow, it's like medical big brother."  They mentioned vests that monitor most of our basic bodily functions, monitors that can tell if and when we take prescribed medicine, and other specific monitors for heart function, blood pressure, blood sugar, etc.  While these could be beneficial for people already trying to manage chronic health problems and even be useful in lessening the dependance on medication and monitoring the effectiveness of dietary and lifestyle changes, it would only do so in individuals driven to do so.  I fear that in others with chronic illness and in people who may be borderline or "at risk" this type of constant monitoring would only lead to MORE interventions and MORE medications.  Take the prescription monitoring bit- yes, it would be beneficial in that it would help remind those who actually need antibiotics to finish the round, making them less likely to succumb to future infections and less likely to spawn antibiotic resistant strains.  BUT what if a doctor prescribes antibiotics and the patient chooses not to take them.  What would happen then?  Would the doctor refuse to treat that patient further, as some doctors do now when parents choose to not vaccinate or limit/delay vaccinations?  How much control over our own medical care would we loose?

And my last reaction was "really, this probably won't affect me much."  In fact, I had thoughts that this might drive even more people towards more natural care providers.  If we reach the point where our care is so streamlined that we either don't deal with a person or deal with technically trained intermediaries whose sole job is to examine and report, we will begin to crave the connection with a real person, one who knows us, knows our medical history, and knows their field.  This will drive more and more people to Midwives, Naturopaths, Acupuncturists, Herbalists, and Chiropractors.  Even now, without this technology, more and more people are choosing natural health care practitioners because of that connection- take prenatal care, for example.  The average OB spends 5-15 minutes with a patient at each exam.  The typical midwife spends at least 30 minutes with each patient, often more, especially on an initial consult.

I know this is a loaded question, but what do you think? 

1 comment:

Kori said...

Wow. I think creepy. I agree with your last thought. If I choose to take my baby to the doctor for an ear infection (so the infection can be documented in case we do NEED to do tubes later and to rule out other problems) but then choose NOT to take the antibiotics (since most ear infections are viral) - I don't think it's the doctor's right to take that information any further. I also see there being many more cases of child protective services intervening in families because they refuse medical treatment. It happens too much already, but if doctors know mom doesn't give the antibiotics (for example) then I believe it would only increase.
I also think we do rely on technology too much. I do love my gadgets. But what happens when the power goes out and we are only used to machines gathering our details? What if the machine shorts out and you can't get the help you need quickly because we rely on the machines?
Also, each time information transfers there is a change in information. Think of the game Telephone or Gossip. Much of a physical exam is subjective and that is the benefit of seeing one doctor over an extended period. One symptom may be normal for you but abnormal for me - and this is known by a person who communicates and thinks - not always recognized by a machine OR an untrained lay person. Plus you are transferring info to a machine and then to a non-medical trained worker (if I read that correctly) before possibly on to a doctor?!? Not a chance for me. Too much information changing around and I don't want someone not trained in medicine telling me what to do. A doctor is trained in their speciality area - but before that they are trained in the entire body and how it works together and impacts certain aspects, and in every medicine and how they work together and impact each part of the body and each problem and how it all interacts. A person without that specific whole picture training is going to miss things and misunderstand things. Yes, the medical system is completely broken. But I can't imagine that handing it over to the government (which is also completely broken in my opinion) will fix it.

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