‘You use four senses in the diagnostic process: auditory, visual, tactile and smell.’
These words from a medical school lecture in the dim and distant past came back to me recently, with the talk of how artificial intelligence will replace doctors in the future.
I have no evidence of a direct family link to Ned Ludd, but I certainly share some of the values of his followers. It’s not that I dislike technology for the sake of opposing change, it’s more the fact, in my experience, new innovations rarely live up to expectations and frequently disappoint.
The recent announcement by Jeremy Hunt of the ‘NHS App’ is a good example. This app is supposed to allow patients to book GP appointments, view their health record and order prescriptions. At best this is window dressing to distract from a crumbling and chronically underfunded service. At worst this is going to create more patient frustration by stoking up the expectation of appointments on demand from a service already stretched to snapping point.
Show me a bit of software that can discover a patient with back pain and eczema is attending because it is the anniversary of their father’s death
Many patients are naïve in an almost medieval way where modern technology is concerned. I have lost count of the number of times patients with conditions ranging from cataracts to piles have turned to me and asked: ‘Can I be referred for laser treatment?’ I guess a generation who grew up watching laser guns being fired in space films cannot help but imagine there is something magical about them. When I explain a laser is just a more accurate way of burning something their faces usually drop.
Medicine is almost always a face to face business. You need to see and hear and be able to touch and smell the three-dimensional patient to make a diagnosis. Virtual and telephone contact with patients will always have a place, but only on the periphery of proper blood and guts visceral medicine.
Despite what the technology experts would have us believe, the human brain is still the most sophisticated machine on the planet. Show me a bit of software that, in ten minutes, can discover that a patient presenting with back pain and eczema is actually attending as they are low in mood because it is the anniversary of their father’s death. The day a machine can do that I will gladly resign.