A recent study hits too close to home:
“Deskilling and adaptation among primary care physicians using two work innovations” says, essentially, that as primary care docs try to use innovation like EHRs and clinical guidelines, we become less trustworthy to our patients, less confident.
Or as I’ve put it elsewhere here: I don’t want to become my patient’s data-entry-technician. I feel like a push to gettting better visit summaries has led me to pay less attention to my patients and to rush through patient education.
I’m considering doing a brief video about deskilling. Here’s my manifesto/script.
Hi, I’m Jonathan. I’m a doctor and a geek.
13 years ago, I went to Medical School to become a generalist, a “personal physician”.
For 7 years, I learned about patients and diseases and treatments.
I love talking to people and trying to help.
As a geek, I’ve been exploiting technology in doctoring.
It’s my external brain that lets me know and do things I couldn’t otherwise.
With technology, I could practice like a modern doctor.
When I heard about Meaningful Use, I knew I’d be a shoe-in because I’m geek and because I know my EHR like the back of my hand.
Still, just to be sure, I made macros to polish my usage so I could do Meaningful Clicks and still focus on the people I care for.
Unfortunately I only have so much attention bandwidth: when I’m focusing on clicking a button I can’t be focusing on a facial expression.
Even with a respected EHR and a macro-enabled workflow, Meaningful Use is tarnishing my bedside manner.
Healthcare tech is de-skilling me and making me into a data-technician.
We ought to stop deskilling — we all need thinking doctors, not checklist completers.
We need tools that respect physician attention and keep doctors human.
We need to automate and simplify necessary data capture so docs can focus on patients.