Wednesday, February 10, 2010

Telemedicine and The Virtual Doctor

Imagine this for a moment. You sit on the toilet at home and a urinalysis is performed automatically. Once you finish your “download”, information about renal function and glucose is uploaded to your doctor. You then look into the mirror which contains a retinal scanner, step on a scale, hold onto a special grab bar and tons of medical data streams to your ubiquitous electronic medical record. A galvanic skin sensor checks your anxiety level and automatically dispenses the right amount of Xanax. Or maybe it plays the right kind of music while you shower. Sounds far fetched? Not really. This technology exists today.

The military has always been a source of scientific innovation. Remember they are the ones that invented the internet. Surgeons sitting at a computer at Walter Reed Hospital are now able to assist battlefield surgeons operate in remote areas. In the same way pilots use joysticks to fly drones over enemy territory, doctors can perform remote robotic surgery by using the "DaVinci System”. This is a device which is now available in community hospitals. Critical care specialists can monitor their patients in the ICU virtually, by watching steaming video from bedside cameras. Tele-Radiologists in Australia are reading late night X-rays in taken in NY through the Night-Hawk system. Recently, a study showed that doctors can accurately diagnose appendicitis by viewing CT scans on their iPods. The Journal of Telemedicine and Telecare is full of articles about the advancement of medical care through technology.

There is no end to our fascination with technology. ….especially for those of us who remember huddling around a neighbors TV to watch a rudimentary graphic of a peacock fill with color. Yet, I sometimes wonder when enough is enough. Do we really need things to be more complex and so remote? Since the time I saw my first TV, obesity rates have skyrocketed and for the first time our life expectancy is decreasing. We are leaving more and more garbage around for subsequent generations to clean up. Don’t get me wrong. I love technology just as much as the next guy. But I can certainly imagine scenarios where it just can’t be right.

Will technology replace me with some virtual doctor! Juxtapose the scene where your doctor walks out of the OR with sweat on his brow with the scene a robot in a Woody Allen Sleeper-like movie. The LED message scrolls across its face, “It was touch and go but we were able to save him”. I don’t want someone that looks like my Wii fitness coach telling me I have cancer. What about compassion and caring. What will happen to the human touch and the reassuring smile that only a real doctor can give!

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