Nahum Kovalski

My Future, My Enemy ?

The following blog post is a response that I wrote to an article that I read online. You can see the original article, and the comments on the article, by clicking here. I will forewarn the reader that my comments, as they appear below, are harsh and reflect how offended I was by this article. The time has come to directly address a perspective held by some physicians, that technology is the harbinger of disaster. Everyone is of course free to think whatever they wish and even to express such feelings in public. But it is important to answer such individuals so that a reader can, at least, see both sides of the argument.

This article is far from the only one that, through its own content or via comments on the article, find it appropriate to equate some aspect of modern healthcare with Nazi Germany. As a Jew, a physician and a medical IT person, this article and its comments managed to be amazingly insulting and insensitive at multiple points. Amongst all the comments, there was only one that was well thought out and appropriate. The first comment made the appropriate observation that the future of healthcare will be radically different from what it is today. Ultimately, that future would not in any way or form create worse individual care, but rather would be a golden period in which patients receive customized care via technologies that are far less invasive, cause fewer side effects, and are far more effective.

At one point, one of the comments by a physician states the following: “My personal observation is that a lot of medical IT people strike me as con men”. I must say that I feel very sorry for the physician who made this comment. Clearly he lives in an area where the quality of medical IT specialists is horribly poor. I am a medical IT specialist and I have worked with many medical IT specialists and I have yet to meet one or speak with one who would in any way merit being called a con man.

Let me suggest an alternate theory for the radical negativity that some doctors openly express against future innovations. My theory is that some doctors are severely lacking in an open mind and an innovative approach to medicine. These same doctors are extremely frightened of losing their dominion over anything medical. They do not care about medical literature that clearly indicates that simply washing one’s hands before seeing the patient would drastically decrease infections. Apparently, such research is totally meaningless if it does not jibe with these doctors’ personal experiences.

The writer of the article complains that he has lost his ability to develop his ideas into products that would positively affect healthcare. Perhaps the writer is unaware of the revolution that manifests as countless startups all looking for new and innovative ways to improve our lives. If the writer is in fact technologically oriented, then he would not have difficulty finding a startup [or creating one] that would take full advantage of his combined medical knowledge and experience as well as his technological bend. How anyone could bemoan the loss of the power of imagination in today’s world is beyond me.

Clinical assist tools that are integrated into electronic medical records continuously watch for human error and counter it before it causes harm. There are those who romanticize the “old way” of practising medicine. The painful truth is that a pure human approach to healthcare leads to hundreds of thousands of patients dying every year from medical errors. In today’s world, patients still suffer from the very human error of operating on the wrong side of the body. I would hope that everyone welcomes a technology that double checks the actions of a physician.

It seems that some physicians believe that they should not be held to any standard based on evidence-based medicine. The guidelines that the author refers to as being constricting and denying a physician to add personal input, are themselves created by fellow physicians who are expert in the various fields that the recommendations cover. These recommendations are not the fruit of one’s personal opinion but are the result of reviewing the literature and finding the best approach based on accepted statistical analyses of approved clinical studies. When anyone remembers how doctors of old were much more attentive and caring, they should also realize that the doctors of old often had no idea what they were doing and what was best for their patients.

The day will come when computer guided care is shown in repeated clinical studies to surpass medical management by humans. It may take 20 years or 30 years or 50 years. But there is no question that computers will provide better diagnostics, better treatment selection and better outcomes than humans do today. At that point, doctors will have to fundamentally redefine themselves. Of course, there will be those doctors who choose to wear blinders and continue to ignore what everyone else knows. And, there may very well be patients who would rather be seen by a human, despite the inferior quality of care. But most people will appreciate the 24/7 availability of a computerized healthcare system as well as the superior results of such a system. There will be some doctors who will still rant against technology, even in this future time. I wish them well for in my opinion, they will be a lost cause.

I must say that I consider myself blessed to have trained both in technology and medicine and to have been a personal witness to the incredibly positive effect that technology has had on healthcare. Also, I consider myself lucky that my arguments in favor of anything, do not need to resort to histrionics and Nazi references in order to make my points. This article should be shared as much is possible. It is time that patients realize that some doctors ultimately have nothing to offer except mindless fear. I truly hope that the generation of doctors who have grown up with technology will understand that it is a friend and not an enemy. I certainly hope that overseeing committees and associations will effectively ignore such anti-technology articles, and move on with encouraging physicians to be part of the future.

I have no doubt that my comments will have absolutely no influence on Luddites who refuse to consider that technology is a positive thing. I can only feel remorseful for those people who are treated by physicians with such opinions. And I can only hope that these same patients will eventually realize that they must move to doctors who are forward thinking in order to get the best possible care.

No matter how horrible present conditions may be for a group, there are those who would rather continue to live under such horrible conditions than to move forward into a new world. Fear of change is a constant that reaches back to biblical times. Thankfully, we have been born into a world that offers those, with the desire for a better world, to create one.

About the Author
Dr. Nahum Kovalski received his bachelor's of science in computer science and his medical degree in Canada. He came to Israel in 1991 and married his wife of 22 years in 1992. He has 3 amazing children and has lived in Jerusalem since making Aliyah. Dr. Kovalski was with TEREM Emergency Medical Services for 21 years until June of 2014, and is now a private consultant on medicine and technology.
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