Seventy-two years ago, I聽arrived in Boston. I鈥檇 been accepted as a student at the Harvard Medical School. That night, a full moon shone on the school鈥檚 white marble buildings, an awe-inspiring sight I鈥檝e never forgotten.
I recently returned for a 68th reunion, attended lectures and, as a former student, was interviewed by a film crew. At one point the interviewer asked: 鈥淲hat are your thoughts in this robotic age of medicine?鈥� His question reminded me of a comment I鈥檇 heard years ago. A White House reporter asked an assistant working with former U.S. president Franklin D. Roosevelt: 鈥淒oes the president really understand all of the economic bill he鈥檚 presenting to Congress?鈥� The aide replied: 鈥淧ossibly not, but Roosevelt understands how to be president.鈥� He implied that some presidents never learn this important role.
Today, in an increasing electronic world, some doctors never learn to be doctors. In the computer age, it鈥檚 understandable. Many readers have probably encountered this 鈥� young doctors so weaned on computers they spend more time typing reports into a screen than talking to, examining or looking at the patient.
This led to another question: 鈥淲hat did I think medicine would be like 50 years from now?鈥� I聽replied that we were already witnessing a dramatic change in how medicine is practised. Today, the average family doctor spends barely a few minutes with each patient. This is not the doctor鈥檚 fault. It鈥檚 the fault of the harried system. For example, when a vastly overweight person enters the office, doctors know a number of problems are either present or imminent. There鈥檚 a good chance that Type 2 diabetes will occur somewhere down the road. The doctor also knows that with Type 2 diabetes, there鈥檚 a 50 per cent chance of heart attack.
So how can any family doctor, in a few minutes, solve that problem? The point is, he or she can鈥檛. In the future, doctors will have assistants. One that will advise what鈥檚 wrong with food in the patient鈥檚 pantry. Another will prescribe a shopping list for good food choices. Another will arrange an exercise program in the gym. Some corporations are already paying for this new approach as they realize it will prevent tons of medical expenses later on, while treating chronic disease that should not have happened.
Since I spent my medical life in surgery, I was asked what would happen in the OR down the road. Even today, some surgery is done by robotics. I have no doubt this will increase and benefit patients in many ways, by reducing time and error.
I left this Harvard trip knowing the future of medical care is in good hands, but both doctors and patients will have to adapt. Patients will have to accept that computer medicine is here to stay. Doctors will hopefully learn that patients still exist who have fears and need eye-to-eye contact.
Harvard is educating more students who become professors and researchers. But family physicians must still have a major role. During the filming, I told the story of one such case. One morning after surgery, I returned to the recovery room to check on my patient. I noticed three doctors leaning over the bedside of another patient. They were worried about the patient鈥檚 breathing.
The surgeon, anesthetist, and an ear-nose-and-throat specialist had been summoned for an opinion. All believed the patient was suffering a serious respiratory obstruction and were arranging emergency tracheotomy. The family doctor suddenly arrived.
He listened to their opinion and then listened to the patient鈥檚 breathing. Stepping back from the bed, he said: 鈥淚鈥檝e known George for 40 years and he鈥檚 always breathed this way.鈥� Surgery was cancelled. In this, a computer could not compete.
Regardless of how medicine changes, it must follow the advice of one of Harvard鈥檚 great teachers who remarked: 鈥淭he secret of caring for the patient is caring for the patient.鈥�
We don鈥檛 yet know whether the computer can learn to do that.
