Wired Docs

Some years ago, I had the good fortune to get in touch with a woman who's a cardiologist on the west coast. It wasn't exactly a professional contact; though I was asking for her opinion, it had to do with the use of computer technology in the support of medical practices. Over time, we've exchanged other notes, and though we've never become as close friends as I'd like (something about being two thousand miles away figures into it, I suspect), I've valued our continuing contact nonetheless. She's a sharp, insightful person with a wicked sense of humour.

I recently asked her opinion on something that seems to be a growing condition without an answer: people who have serious, perhaps life-threatening diseases, and don't know where to go for information. Of course, the primary source for this is your local medical practitioner, but, short of coming into the office with a thick wad of prints from the internet (generally frowned upon) or calling them all the time (equally frowned upon: its not a money maker, interferes with other parts of the practice, and usually results in having to have an on-site visit anyway (if its a visit, why doesn't anyone bring presents, I wonder? A little hostess gift?)). So where does a person go for background information on their condition, implications, and cure?

Well, I thought, for starters, I'd ask someone who'd know for sure what she does when she wants to point someone to information -- where does she get it from? Experience surely plays a role, but is it purely or mostly that? (Because, if it is, the idea of getting information from outside that single channel would seem to be a nonstarter.) So far, the answer seems to be: yes. Its got to be vetted and massaged by a doctor, because no one else can interpret and apply the multiple sources of information. You need the medical training to do that.

I'm having a hard time accepting that. Training for diagnosis and treatment, absolutely. But just to know what its all about, what it means to you, what kinds of questions you ought to be thinking about, and where you go to start getting answers? I'm not at all sure about that. Some of that attitude, I suspect, is based simply on the fact that so much of what they do literally is life and death, and no sane person wants to take a chance with that. When they see computer based systems that are almost but not totally accurate, they cringe, and say that they need to be totally accurate before they can be used. Thats an awfully high bar to meet. And beyond that, they likely feel, you've got to apply a modicum of personal judgement based on your knowledge of the patient -- knowledge of where they fit in the general population, what their quirks are, whats unique about them. No computer can do that, so you're back to square one.

But doctors and their analogs are a limited resource. Computer systems have to be able to augment and supplement them. There's got to be a non-lethal first step. Got to be.