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11/12/18

Docs vs. The Machine

My typical writing process looks something like this…get the morning coffee, launch Spotify for some background music, and then start digging into my healthcare reading folder.  That sounds so much more thoughtful and deliberate than what regular readers would have presumed given the randomness of these musings, doesn’t it?

When I began this morning, I would have sworn that someone or something had changed all my email filters because everything I opened to read was about artificial intelligence…AI for clinical decision support, AI by payers for pre-authorizations, AI for polyp detection, AI to suggest new epithets for you to mutter about the AI takeover of the world. 

Maybe the machine was taking over my blog.  Maybe you all joined in to crowdsource the funding of that idea.

Literally, the first six or seven pieces I read led with, were dominated by, or were exclusively devoted to news about the advances of artificial intelligence and machine learning in healthcare.  I might not learn as fast as a bot, especially prior to the second cup of Joe, but I was starting to detect a pattern and got a mental alert: ‘Hey, maybe you should write something about AI.’ 

Slow…my processor is a bit old and due for an upgrade.

Then something caught my eye…an article entitled, ‘Why Doctors Hate Their Computers.’ 

Like a good learning machine, I not only detected the pattern, but also the deviation.

At first, I assumed this was just another rant by a doc who hates her EMR…and it was.  But the author was Dr. Atul Gawande, a guy who is not only a good and thoughtful and prolific writer, but the recently named CEO of the venture between Amazon, Berkshire Hathaway and JPMorgan Chase to blow up healthcare.  Maybe this would not be a garden-variety rant. 

The New Yorker article, being a New Yorker article, is a long read, but worth it if you still have the second cup in hand.  He tells the way to familiar tale of physicians hating their EMR.  At least you know that whatever the big JV does, it will be led by a doc whose health system made him sit through 16 hours of Epic training that was so boring that it would have violated the Geneva Convention if it were forced on prisoners of war. 

Almost any physician could have written the piece – it is the common experience. But Gawande, being who he is, offers some helpful insights into the root of the issue that I’d like to explore this week.  Unfortunately, there were no ground-breaking ideas for how to solve the problem (my skepticism about the Buffet-Bezos-Dimon deal is that it is easy for outsiders to show up and tell us what is wrong with healthcare – duh, we live it every day, we know – but solutions are a little harder to come by), but understanding the underlying issues a bit more might help when you are tempted to chuck your laptop out the window.

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ALN

Tim Coan, ALN’s CEO, writes an insightful and witty blog three times a week about a variety of topics relevant to independent physician practices.

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