During our lifetimes, the role of physician has been shrinking, from healer to technician.
You’ve probably seen the famous painting, Doctor and the Doll, done by Norman Rockwell in 1929. It depicts an old country doc listening with his stethoscope to the heart of a doll held up to him by a worried little girl. Today there’s no time for such play, and no pay for it, either.
The gradual transformation of health care from a service to an industry has emphasized science to the virtual exclusion of its art, leaving physicians with little mandate other than to diagnose and treat illness. That’s not a terrible goal, of course, but it leaves the doctor a pure technician and the patient a sack of enzymes in need of tweaking, and we know patients and doctors alike are more than that. If that’s the way we continue to direct medical practice, it’s going to go the way of the passenger pigeon, since we now have machines that diagnose and dictate treatment, and do it better.
Our medical technology is truly astonishing. When I was in training, for example, we’d find the oxygen content of a patient’s blood by locating the femoral artery, plunging a needle into it, drawing off some blood, and then waiting forever for the lab result. Now we just clamp a tiny device onto the patient’s finger, and it delivers an immediate, accurate response.
A gizmo called the Tricorder X, named for the Star Trek device, will be released this year. Working with your phone, it’ll take a blood sample and analyze 54 markers that will identify nearly any disease. Already computers are more accurate than doctors at diagnosing cancer and some other diseases, and once diagnosis is established, treatment is simply a matter of algorithm.
Now, if you ran a health care company, would you rather pay doctors handsome salaries every year and put up with their human messiness, not to mention human errors, or would you replace them with hardware and software that’s more accurate, never complains, and in the long run is far cheaper?
At that point, what will be left for doctors to do? Some superspecialists won’t be replaced by machines, but most docs will find themselves technicians operating sophisticated gadgets, and hardly relating to patients at all.
But there’s one thing doctors used to do — and still can do — that machines will never match, and that is to listen to that little doll’s heart. They can comfort, educate, and guide patients. This sort of intimacy can only be done by human beings sitting together, trustfully conversing. And as health care continues to morph into hi-tech vending machines, that intimacy will be increasingly missed. Just as alternate career training is now available to some workers in dying industries like coal mining, training in human contact should be made available to current physicians. Right now, that training is in its infancy and in fact rare. Let’s encourage it.
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