Digital medicine isn't helping

  • John Mandrola is a cardiac electrophysiologist, a guy who specializes in heart rhythm disorders. He is a vigorous advocate for making smart lifestyle choices as the primary means for achieving health. The notion that preventing disease is better than treating it is too often forgotten, in Dr. Mandrola's point of view.

    In an interesting blog post, Dr. Mandrola highlights what he believes is a loss in the fundamentals of treating patients which boils down to listening to their needs and addressing their problems.

    Instead, with the advent of more and more digital surveillance of your vital signs, medicine risks looking at the numbers more than the people. Addressing the problems with people's data is not the same as addressing the people themselves. 

    Anyone who has been to a doctor recently or needed medical care will probably related to this post.

    What makes the practice of medicine work well is not at all complicated. It starts with a story. What is a person’s story? A BNP level, a set of shadows on an ultrasound, a white count, a rhythm strip with squiggles, these are not stories. I begin almost every new patient visit with words like this: “What is bothering you most…I want to know what you say, not your doctors.”

    When I do this, it is as if magic occurs. I met with a clinician a month ago at the Heart Rhythm Society meeting in San Francisco. He told me something that I’ll never forget about the patient encounter:

    I can almost always tell within a few minutes of meeting an (AF) patient what the correct treatment will be. It’s as if God himself speaks, and tells me the right course for that patient.

    I know that sounds like hyperbole, and maybe it is, a little. But what it highlights is the power of observing people, their faces, their clothes, their families, their reading material. You simply cannot know the correct course for a person from a chart, an x-ray or an ultrasound.

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