As I watched venture capitalist Vinod Khosla rail against physician misdiagnoses and advocate minimizing their role in the examining room in favor of medtech, it was great to see his point of view contrasted with Dr Abraham Verghese of Stanford Medical School. Verghese’s perspective offered a breath of fresh air to the discussion, championing the value of a physical diagnosis, reminding the audience the value physicians offer and what might be lost by dismissing their significance.
He might describe himself as a traditional physician, emphasizing the importance of human contact in the exam room, but Verghese carries some fairly non-traditional devices in his black doctor’s bag, such as a portable ultrasound device.
It was a neat contrast set up by the organizers of Stanford Graduate School of Business’ Healthcare Innovation Summit and made for some decent theater. Khosla talked about the pervasiveness of misdiagnosis and role that good doctors could play in improving the next generation of diagnostic tools to make them and sub-par doctors better at what they do and the benefits of surgically removing compassion from the diagnostic process. Verghese championed compassion as a medical tool of sorts that’s important to communicating a diagnosis to patients and quoted Francis Peabody: “The secret of the care of the patient is in caring for the patient.” Khosla was passionate about the need to be dispassionate.
He even got Khosla to temper his argument a little from saying 80 percent of what doctors do will be done by machines to saying that technology amplifies what physicians do and can improve their performance.
“I am not minimizing the fact that emotions play a role,” Khosla said at one point, “but a tool devoid of comfort can be an effective diagnostic.”
The best thing about pairing Khosla and Verghese wasn’t just the fact that they each had important points to make. It was that you couldn’t listen to them without rethinking, even a little, the balance of technology and human contact to improve patient outcomes, particularly as physician shortages deepen and individuals are confronted with tougher decisions on the best way to allocate resources for their healthcare. It should be required viewing, particularly for those who feel 100 percent committed to one perspective or the other.
Although I am happy to see technol;ogy in the Healthcare field, I believe the hands on approach used for diagnosis is vital to effective patient care. I an era of more and more software being used for patient care, the possibility of misdiagnosis will become more prevalent as the population uses online tools to self-diagnose. This is already a problem with the nowe general use of computers in this country and many others.
Jackie Ca\macho, LVN
@Clinithink Do you know if there is any online video of that discussion?
We agree - we have a tool that utilizes a database of patients with known outcomes 45 days after discharge so that when a patient presents to an emergency department with symptoms of life threatening disease, the physician can enter 8 variables and submit it to the database and then be returned with the exact patients in the database that match the presenting patient. Since the outcomes are known with the patients returned, the physician can see the likelihood of disease and determine action needed based on this probability.