After a night of turbulent air travel home from the American Academy of Family Physicians Conference this weekend, I relaxed by watching a NOVA documentary on— what else —air travel. This particular program investigated Air France flight 447, a flight from Brazil to Paris which crashed into the Atlantic Ocean on June 1, 2009, killing 218.
A team of independent investigators compiled evidence from the plane wreckage, weather conditions, transcripts from radio communication, and reports from past malfunctions of similar aircraft. It was determined that the plane had encountered a severe thunderstorm, which coated exterior speed sensors with ice. This caused the automatic flight systems to shut off, leading rapid deceleration and an eventual stall of the plane. A flight simulator was set up with similar conditions to that faced by the pilots of Flight 447. During the simulation, experienced training pilots relied on their manual skills to fly the plane, and immediately took control to right the plane. It was postulated that the pilots of Flight 447 may not have had the training to manually maneuver a plane out of complex situations, due to the over-reliance on automated technology. Once the automatic system failed, they may have hesitated to take manual control, advancing into an irreversibly, and ultimately fatal situation.
How does this apply to medicine? In this day and age, the growth of technology has been exponential in the healthcare setting. Digital imaging, electronic medical records, nuclear scans, Doppler ultrasounds, tablets and laptop computers have all become commonplace in America's hospitals and clinics over the past decade. Vital information regarding patient treatment and history is stored digitally. Simultaneously, blogs and editorials have been published describing the "death" of the physical exam, criticizing the ineptitude of recent medical graduates performing basic exams and missing obvious signs.
Like the crew members of Air France Flight 447, we are highly trained professionals, tested and trained for the worst-case scenarios. We are very comfortable with technology, and do our jobs using electronic tools as aids. This is sufficient greater than 90% of the time, but what happens when we encounter situations which void our tools? Can we effectively rely on "manual" medicine (inspection, auscultation, palpation, percussion) to diagnose and treat? Can we function without "autopilot" applications and calculators? Are we less adequate physicians because of our reliance on technology? And, in the worst case scenario, will our inadequacy cost lives?
This is a very interesting thought...although I think that it takes the talent of the doctor's to read the results of such test....yet alone learn how the technology works. I do not think that it takes away from what the doctor has to offer, I think it adds to the tools that the physicians have to make a more accurate diagnosis.
ReplyDeleteI also think that the physicians should be trained to diagnose without the technology incase there is a natural disaster or power outage.