Young Doctors. Saviors of the System?

Last week I asked two friends what they thought about emerging technology in healthcare. One is a second year resident at a well-respected hospital. The other is in the last year of dental school and will soon be off for a residency in pediatric dentistry. Their comments below give me great hope for the future.

Curiously, they both failed to capitalize their sentences. I feel that there is an important insight in that fact, yet I can't quite put my finger on it. But I digress...

From the young dentist:

technology has transformed healthcare as i'm sure you well know. research is constantly changing dentistry's techniques and the materials we use. for the average patient, dentistry is somewhat of a mystery. most people don't look inside their mouths and check what kind of work the dentist has done. the internet has better educated the average patient immensely. or even chairside, i've used my iphone to pull up videos and photos of examples of treatment. i've used translation apps on my iphone to better communicate with my spanish speaking patients. my iphone syncs to ical and if u had a .me account it would sync automatically. but most offices have their scheduling done by the front desk staff.

in high end practices it is common to have intra oral fiber optic cameras that display their images on an LCD so that a patient can see exactly what you're doing in their mouth as you talk to them. this greatly ups the transparency because many people think dentists can be shady. in pediatric dentistry its common to have lcd tvs playing tv or movies chairside, to distract and occupy the child patient.

digital radiographs have transformed the field as well. although generally agreed upon as slightly less detailed than regular radiographs, they are sweet because they're fast to take and no wait to develop. you can store them on a computer, print them out if the patient wishes to have a copy, and email them to referring dentists for second opinions and etc. you can manipulate them on a computer in ways that aren't possible traditionally, like contrast, brightness, etc. there is also less radiation exposure per xray taken. also there is the benefit of showing the patient the digital xray on a big computer screen or on my iphone versus having them squint and try to see what i'm talking about on a little traditional xray.

in dentistry there are tons of gadgets that are constantly being developed. like a mirror/light/suction all-in-one. theres also something called isolight that is an all in one thing. theres also laser dentistry. watch the video, shes a pediatric dentist too. i've used this thing before. its pretty cool. also notice her mirror doubles as a light. 

From the young doctor:

iphones in the medical field are slowly becoming more and more popular. on rounds we had a pt (patient) going for surgery and we needed to figure out whether pre-op antibiotics were needed or not.  my intern looked up the newest recomendations put out by the infectious disease society on his iphone before the attending asked him that question, and he had the answer before he got asked and looked like a superstar.

also some doctors carry around lil medical calculators that calculate lil things like how good your kidneys are based on your weight and body mass and other little numbers so u dont have to go the internet for that...its already on the pda.

but every hospital and doctors office has been talking about ehr ever since i was an undergrad.  the problem is how expensive it is to convert everything.  old files need to be scanned, servers need to be bought to house the system...it adds up.

then there’s the school of thought that nothing will ever replace the way a doctor and patient interact and that human to human touch and all these machines just get in the way of actually helping someone who is sick.  like if a pt wasnt sick or coughing and had no fever and no other symptoms, but on the chest xray it looks like pneumonia. you could hold antibiotics and treat the patient instead of treating the xray.

im not totally against the advance forward with technology.  i like having the ability to view my pts old surgery records while i sit on my couch at home instead of going to the surgery records dept in the hospital.  our generation definitely views technology in the medical field differently than the generation before us and we are ready to embrace it more.

In Summary:

At frog, we've been having a lot of discussion about where in the provider community real, technology-driven change will happen. I believe it'll be among specialists (e.g., dentists, cardiologists, dermotologists, etc.) The business case for new technology investments for general practioners is just way too vague because they see too many people with various issues. However, dermotologists can pinpoint if a new IT system will improve their operations because they have much more consistent workflows.

I also believe change will happen with the new crop of doctors coming into the system. Young doctors have been using computers and mobile phones their entire lives. To them, paper records seem ridiculous and they are capable of quickly adapting to new technology. Hopefully, they can drive enough demand that old workflows and systems can be uprooted and changed. There will likely be a tipping point where it changes suddenly and rapidly. New, young doctors will gravitate to more technologically advanced practices and they will force a sea change. Old school doctors will have to change their practices or watch their business slowly fade as they become relics of a bygone era.

One can only hope.

— David DeRemer, Senior Strategist, frog New York