[PEN-L:28043] reply on"Why are Drs afraid of computers" story

[Hari Kumar <hari.kumar@xxxxxxxxxxxx>]

ORIGINAL NOTE: was:
"full piece at:
http://www.boston.com/globe/magazine/2002/0714/coverstory.htm
What your doctor doesn't know could kill you A computer program that
provides vast amounts of information for diagnosing and treating
patients could revolutionize the practice of medicine. So why won't
physicians use it?"
REPLY: There is an amazing picture by Joseph Derby at the London
National Gallery - which I use in my talks to medical students to urge
them to get beyond the "'Wow!' Factor in Science" - it depicts a
cockatoo dying as oxygen is being sucked out of a glass vase, performed
as a sort of an after dinner-party trick to an amazed audience including
wide eyed adults & children. The painting was in the wake of recent
discoveries of the properties of oxygen. Without having read the
original scientific articles that might underpin the Globe article (I
will try to follow up); some cautions:
i) There is very little resistance that I am aware of in tertiary care
medical institutions/medical schools and also primary care units & GP
offices to the potential utility/power of advanced diagnostic methods -
in especial to computers.
ii) The tendency to see new gizmos/techniques/tests/drugs etc - & to use
them willy-nilly, without independent validation by Randomized Trials -
is in fact far more prevalent a tendency amongst the medical and nursing
establishments, than to run from new advances.
iii) If a certain wariness is present in some members of the
establishment, it might be explained by the history of RCT's in the area
of computer diagnostics that have been shown to be negative (including
one I recall of diagnosis of acute appendix - admittedly a not uncommon
disease rather than the very rare diagnosis discussed in the article).
Remember that medicine is rightly - an art & a science. (I trust that
this statement is accepted in the spirit that I do not say that to
justify mumbo-jumbo at all).
iv) There is a general tendency on the left to accept that doctors are
necessarily members of the ruling class - I fully realise this is not
the thrust of the article, but somehow it is implicit in the thinking of
the left. They are not. They are I submit, once usually petit-bourgeois
who are being/have been proletarianised, & who often have a false
conciousness that they are indeed - members of the 'ruling class'; or at
least have more to gain by allying themselves with the ruling class than
with any other societal class. That word "proletarianised" might raise
hackles, & I might myself back off from that word - perhaps. But the
general problem is encapsulated - that of obfuscating "Who exactly is
the enemy?" In the process, it probably is true, that old-fart type of
nuerologists depicted in the article may well in a Pavlovian response,
defend their turf. However, this defensive reaction is far from general
in my own experience.
Cheers, Hari Kumar