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Why Doctors Reject Tools That Make Their Jobs Easier

blogs.scientificamerican.com

111–120 of 131 posts

Re: Why Doctors Reject Tools That Make Their Jobs Easier

#111

Earlier quoted context omitted.

Health services are in service of the patients, not on your commoner opinion of what health should be and how it should be imparted.

Most people taking homeopathic medicine want their symptoms to get better. It’s not as though they have some different definition of a “good health outcome,” they’re just mislead about the effects of the what they’re buying.

Placebos work. Sad but true.

Re: Why Doctors Reject Tools That Make Their Jobs Easier

#112

Earlier quoted context omitted.

This is not unique to software. Physical objects also benefit from iterations in development. That doesn't mean you have to update things you've already sold. The iteration happens when people buy the next version. This used to be how software was sold too.

I believe GP's point is that you won't even make the first version of the software good if you aren't allowed to iterate on prototypes, with feedback from actual end-users.

The first version doesn't have to be good. It just has to be plausibly better than not having that software or device.

Re: Why Doctors Reject Tools That Make Their Jobs Easier

#113
post #69

Earlier quoted context omitted.

Its really strange how much punishment doctors seem to receive and how much they're willing to take. The hours alone would be laughable in any other industry.

The hours are, to some extent, imposed by the various medical governing bodies either directly or by artificially restricting the supply of doctors. These bodies are composed largely of doctors so the problem is to some extent self imposed. In the UK doctors are not governed by the working time directive because the UK negotiated an opt out so hospital doctors work ridiculous hours. As far as I can tell this problem…

>In the UK doctors are not governed by the working time directive because the UK negotiated an opt out so hospital doctors work ridiculous hours.

In UK doctors are treated much worse than they are in the USA.

Re: Why Doctors Reject Tools That Make Their Jobs Easier

#114

Earlier quoted context omitted.

Safety first, full stop, no exceptions. Until correctness can be done easily in accessible programming languages with a decent developer pool, iteration in this space, along with other life-critical spaces such as trains, planes (and wouldn't automobiles be nice too?) is sadly a long, manual process compared to web development. Edit: to expand a bit on correctness, think Coq but with the ease of Java or Typescript. E…

Coq but with the ease of Java or Typescript Don't hold your breath. There is currently no technology on the horizon that holds a promise to bring use even close to what you ask for. Note also that Coq/Isabelle/Agda and their successors will still suffer from a variant of the oracle problem : where should the specifications come from? Finally note that almost virtually aviation software is formally verified in with in…

I was thinking more of that would be (a or the) barrier to rapid iteration in medical software, not that it is likely to be achievable. Given the rigorous testing required in its place, we don't get web dev agile style iteration in medical software.

Re: Why Doctors Reject Tools That Make Their Jobs Easier

#115
post #52

Earlier quoted context omitted.

> Every CT scan increases your odds of cancer. There is no evidence for that statement. More specifically, there is no evidence that a single radiation dose below 100mSv is harmful at all, but plenty of evidence (Taiwanese radioactive apartment buildings, nuclear navy worker study) that it isn't. Muller made it up for political reasons.

There is evidence: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3660619/ > Title: Cancer risk in 680 000 people exposed to computed tomography scans in childhood or adolescence: data linkage study of 11 million Australians > Conclusions: The increased incidence of cancer after CT scan exposure in this cohort was mostly due to irradiation. Because the cancer excess was still continuing at the end of follow-up, the eve…

This study is solely focused on childhood and adolescence CT scans. Any radiation dosage you take during childhood has magnified effects.

Re: Why Doctors Reject Tools That Make Their Jobs Easier

#116
post #78
post #5

Flashy article title clickbait. Doctors are not fools. If a tool truly made their job easier, it would not be rejected out of hand. Job security for physicians is rarely the issue, there are plenty of sick people.

>...Job security for physicians is rarely the issue, there are plenty of sick people. Yea you would think so... Unfortunately, in medicine, just because a computer program is better then a Dr at diagnosing a patient is no guarantee it will be used. The classic example here was the MYCIN expert system developed in the 1970s. MYCIN was shown to outperform infectious disease experts by 1979 in a blind testing: >... Eigh…

There are good reasons why MYCIN and similar systems were never accepted, mainly the fact that diagnosing an infectious disease is pretty useless on it's own. If the doctor has already narrowed it down to an infectious disease, telling which one it is is trivial. The hard part is getting there.

Re: Why Doctors Reject Tools That Make Their Jobs Easier

#117
As a med student, using shinny new tech in medicine has become a dick measuring contest. There is absolutely no fear of new tech, just professionals rejecting useless unoriginal products that don't actually make our jobs easier. Like the data fad that will just make us manually reenter data into a new data silo for the benefits of other companies who will take no responsibility to the stability required in the field. I absolutely resent some of the interfaces we have to use but at least the CT/MRI reading software doesn't crash. Anything new and shiny does though.

Re: Why Doctors Reject Tools That Make Their Jobs Easier

#118

Earlier quoted context omitted.

I believe GP's point is that you won't even make the first version of the software good if you aren't allowed to iterate on prototypes, with feedback from actual end-users.

The first version doesn't have to be good. It just has to be plausibly better than not having that software or device.

Sure. But most of the time, the first version is worse than having no software, by the virtue of interfering with existing workflow.

(This is what you get when you design for those who pay for your software, and not for those who'll use it.)

Re: Why Doctors Reject Tools That Make Their Jobs Easier

#119

Earlier quoted context omitted.

There is evidence: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3660619/ > Title: Cancer risk in 680 000 people exposed to computed tomography scans in childhood or adolescence: data linkage study of 11 million Australians > Conclusions: The increased incidence of cancer after CT scan exposure in this cohort was mostly due to irradiation. Because the cancer excess was still continuing at the end of follow-up, the eve…

This study is solely focused on childhood and adolescence CT scans. Any radiation dosage you take during childhood has magnified effects.

Thanks for pointing that out, but, okay, children and adolescents count too?

OP responded to a specific comment, I responded to OPs comment. I don't understand your point in that given context. I'd think showing one study - I didn't bother to look any further - that shows a risk was sufficient.

Since even adults have plenty of still dividing cells left I see it as reasonable to assume that adults are at risk too, even if that will likely be lower.

I also recommend at least the "Conclusion" section of this document, selected as an example, not as the one definite document: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3611719/ It is a good read overall too.

Re: Why Doctors Reject Tools That Make Their Jobs Easier

#120
post #98
post #60

Earlier quoted context omitted.

They really are comically bad (Cerner, Epic, Meditech, all of them), but they are effective data silos which is a step up from having that data silo'ed in filing cabinets. People outside healthcare really don't understand the sheer amount of time your physician spends trawling through the medical record in the regular course of doing his or her job. You can think of the patient chart as a shared "My Documents" folder…

My doctor's office just switched to the latest MyChart system and the app on Android has a pretty modern UX, decent usability and shows all my upcoming appointments, lab results, bill statements, etc. No complaints on my end, having access to my records right after my physician enters it into their computer is nice compared to requesting packets of physical paper then having to securely store them from prying eyes...

Mychart is really slick in my opinion. Very usable Android interface and everything you mentioned. I was definitely impreased for the patient experience. Sometimes with blood tests it can be a bit of information overload. But that is why you have a doctor explain what matters. It's also nice to see and compare previous tests to see things improve in a simple format.
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