Tuesday, October 16, 2012

Brave New World-Aldous Huxley

Brian J. Secemsky is an internal medicine resident who blogs at The Huffington Post. He can be reached on Twitter @BrianSecemskyMD.

Enter “ The Brave New World” of the electronic physician.

This generation of doctors has permanently lost their physician brains, so says  Brian J. Secemsky, MD on October 16th, 2012in Physician. He is a recently trained internal medicine physician recognizes the effects of modern technology on physician’s cognitive abilities.  His observation is probably more acute than most young MDs because his father, real Dr. Secemsky is there to tell him how it was in ‘his day’.

As a physician who has transitioned through the intrusion of electronic computers and smart mobile devices I have used these machines to enhance my already full brain by eliminating some of the rote memorization stored in my head.  I recognized early on the efficiency and the improvement in accuracy of my clinical skills and the added confidence it added to me with the ability to measure my thoughts and answers against a ‘source’ of knowledge.  The mobile device quickly became my KB (knowledge base).

Dr Secemsky  observes 

Four years later and here I am, one hand on the shoulder of patients whilst listening to their afflictions with the other hand already reaching for my iPhone, ready to pull up necessary gaps of my medical knowledge.


         VACUUM PACKED ?                                                          iOS   ACCOUNTABLE CARE

Is this proper way to train as a physician? Surely I’m not the only doctor to sneak out of the patient room like a cheating lover to softly glance at a guideline on UpToDate or straight up ogle a dosing regimen on Epocrates. Yet, this is how many of us Gen Y physicians survived medical school and how many of us will continue to claw our way through residency and beyond.

It’s a fact. Your doctors today do not know everything about your health. But we sure as hell have perfected the art of finding out exactly what we need to provide the right kind of care for you. So the question remains: are the new physicians of the world the adventurers of medical knowledge, paving paths through the vast and ever-widening available online literature? Or are we the lazy college grads living in our mothers’ basements, completely functional yet totally okay with someone else doing all the housework?

To infinity and beyond

Every time I am on the phone talking shop with the real Dr. Secemsky (my father), he never hesitates to counter my complaints about residency with unsolicited anecdotes of what it was like during his training. Back in those days (years? decades?) the only websites around were in unswept cellars and children’s books about Charlotte.

Losing the physician’s brain

So what’s the problem, the reader might ask? In today’s world, where the efficiency of a physician is more important than ever (think of the estimated 30 million more insured Americans flooding clinics and hospitals around the country in the next few years), one might say that online medical resources are the silver lining to our otherwise stormy healthcare system. However, critics of such large and readily available online databases are right to question the effects that these sources of medical knowledge are having on physicians’ ability to critically think on their own.

Take home point

Online medical resources are certainly not the next fad in healthcare. They are likely to become a permanent fixture in the way we as doctors practice medicine. Therefore, it is the responsibility of practicing physicians in every generation to not only learn how to navigate these online tools but also to spend enough time absorbing as much of this vast medical knowledge as possible in order to be able to critically think on their own. Although easier said than done, it’s better for the patient to have their doctor’s brain inside the exam room than left at the computer.

So, for the patient during your next visit, ask your MD if he obtained a second opinion from the internet, or maybe even if he cheated and looked up the answer. (said in humor, but even I wonder).

You may also want to ask if he practices Android medicine vs. iOS medicine.



                     ANDROID MIGRAINE


In addition to the ease of looking up references MDs can also phone home, text, and even video conference using Skype or Google Hangouts. Did I mention gaming?  Overall I think it is a “Brave New World” and a “Better New World” despite some hesitations.


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