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Dr. Robot? Not anytime soon

Stanford Medicine Unplugged is a forum for students to chronicle their experiences in medical school. The student-penned entries appear on Scope once a week; the entire blog series can be found in the Stanford Medicine Unplugged category

Medicine is both an art and a science. But lately, it seems medicine has been leaning more on science than on art— more algorithm and data than creativity. We now make our medical decisions based more on standard practices of care and published guidelines than by using our autonomy and intuition.

We should welcome this shift though. With results from thousands of clinical trials published annually and mountains of digitalized patient data waiting to be sifted through, we are only beginning to learn how to tailor our treatments to our patients and foresee their risk of developing future complications and disease.

At this rate of progress, it is easy to imagine a health landscape in which a computer recommends lab tests and then suggests possible diagnoses and treatment regimens based on the results.

Or put simply, what is to stop us from creating a Netflix or a Pandora for patient care? Nothing, really.

And surgery is not resistant to automation either. We already have the famous da Vinci robot to aid surgeons in performing the nimblest of surgeries. And if Google cars are already circulating the roads while contending with the nuances of human traffic, surely it is not too ambitious to imagine a robot that could navigate the human anatomy as another tool to use in an invasive procedure.

But take a look around: Computing and outsourcing are already disrupting health care. As hospitals push doctors to see more patients in less time while using fewer resources, so proliferates third-party companies that offer telemedicine and other remote medical services — physical exams are done virtually, vital signs from a number of patients can be monitored across the continent by single doctor and imaging scans can be read by someone who lives 12 time zones away. Doctors may be slowly slipping into irrelevance.

So if medicine increasingly relies more on computers and algorithms to analyze and diagnose patients, is there any room for creativity and human connection in medicine? Of course.

Here at Stanford, perhaps the epicenter of bioinformatics research, we have scientists concocting sophisticated algorithms that can help diagnose even the rarest of diseases. And that facet of Stanford overshadows one of our school’s greatest strengths, one that’s strongly emphasized in our curriculum and what may be the lifeline for us as future doctors — the human touch.

From day one, the Stanford faculty constantly reminds us to put a face on the disease. And throughout our preclinical years, we have classes dedicated solely to listening to patients and their families speak about their experience dealing with life-altering and often incurable diseases.

My classmates and I may have learned this lesson too well and its impact shows as we practice collecting a patient’s history. We are all guilty of diving deep into the personal lives of our patients, blurring the line that separates professionalism and friendship. When the average physician now spends less than 10 minutes with a patient, my classmates and I have the luxury of spending nearly up to an hour with them and we take full advantage of that opportunity. Much of that time, however, isn’t spent collecting pertinent medical clues, but on chronicling their personal stories.

We ask our patients about their hobbies, their jobs, their family lives, their vacation plans, their hopes and worries, even their favorite movies and books. If one of us wasn’t wearing white coat, an unsuspecting observer would be convinced that we were two friends catching up at the doctor’s office. In one instance, one of my classmates hit it off so well with his patient they made plans to trade family casserole recipes.

Perhaps it is naïve to believe that the doctor is irreplaceable when job security in every other industry is uncertain. But patients will never stop appreciating the presence of a warm and soft hand on their shoulders during a physical exam and the human voice of sincere reassurance during an annual check-up.

Siri may one day surpass our ability to diagnose a disease, but she’ll never be able to bond with a patient over a family recipe. And even a robot that possesses endless data and computing power won’t able to replicate that ability.

Steven Zhang is a second-year medical student at Stanford. When he’s not cramming for his next exam, you can find him on a run around campus or exploring a new hiking trail.  

Image courtesy of Jorge Barba

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