72 years ago I arrived in Boston. I’d been accepted as a student at The Harvard Medical School. That night a full moon shone on the school’s white marble buildings, an awe-inspiring sight I’ve never forgotten.
I recently returned for a 68th reunion, attended lectures, and as a former student was interviewed by a film crew. At one point the interviewer asked, “What are your thoughts in this robotic age of medicine?”
The Doctor Game
His question reminded me of a comment I’d heard years ago. A White House reporter once asked an assistant working with U.S. President Franklin D. Roosevelt, “Does the President really understand all of the economic bill he’s presenting to Congress?” The aide thought for a moment and replied, “Possibly not, but Roosevelt understands how to be President.” He implied that some presidents never learn this important role.
Today, in an increasing electronic world, some doctors never learn to be doctors. In the computer age it’s understandable. For instance, many readers have probably encountered this situation, young doctors so weaned on computers they spend more time typing reports into a screen than talking to, examining, or looking at the patient!
This lead to another question, “What did I think medicine would be like 50 years from now?” I replied that we were already witnessing a dramatic change in how medicine is practiced. Today, the average family doctor spends barely a few minutes with each patient. This is not the doctor’s fault. It’s the fault of the harried system.
For example, when a vastly overweight person enters the office, doctors know a number of problems are either present or imminent. There’s a good chance that type 2 diabetes will occur somewhere down the road. The doctor also knows that with Type 2 diabetes, there’s a 50 percent chance of heart attack.
So how can any family doctor, in a few minutes, solve that problem? The point is he or she can’t. In the future, doctors will have assistants. One that will advise what’s wrong with food in the patient’s pantry. Another will prescribe a shopping list for good food choices. And another will arrange an exercise program in the gym. Some corporations are already paying for this new approach as they realize it will prevent tons of medical expenses later on while treating chronic disease that never should have happened.
Since I spent my medical life in surgery, I was asked what would happen in the OR down the road. Even today some surgery is done by robotics. I have no doubt this will increase and benefit patients in many ways, by reducing time and error.
I left this Harvard trip knowing the future of medical care is in good hands, but both doctors and patients will have to adapt. Patients will have to accept that computer medicine is here to stay. Doctors will hopefully learn that patients still exist who have fears and need eye to eye contact.
Harvard is educating more students who become professors and researchers. But family physicians must still have a major role. During the filming I told the story of one such case. One morning after surgery I returned to the recovery room to check on my patient. I noticed three doctors leaning over the bedside of another patient. They were worried about the patient’s breathing.
The surgeon, anesthetist, and an ear nose and throat specialist had been summoned for an opinion. All believed the patient was suffering a serious respiratory obstruction and were arranging emergency tracheotomy. The family doctor suddenly arrived.
He listened to their opinion and then listened to the patient’s breathing. Stepping back from the bed, he laughed. “I’ve known George for 40 years” he said, “and he always breathed this way.” Surgery was cancelled. In this, a computer could not compete!
A return to HMS always confirms my early decision to become a doctor. I still believe it’s the noblest profession of all. And that regardless of how medicine changes it must follow the advice of one of Harvard’s great teachers who remarked, “The secret of caring for the patient is caring for the patient.”
We don’t yet know whether the computer can learn to do that.
— W. Gifford-Jones, MD