Do Not Fire Your Doctor

Lot of buzz about a recent WSJ article titled It’s Time To Fire Your Doctor https://www.wsj.com/articles/its-time-to-fire-your-doctor-11549829009 . Here are my thoughts, and in complete transparency, I am a practicing pulmonary critical care physician. Spoiler alert - I dont agree with the article.

Honestly though, I agree with the premise that the tech world has a lot to offer the practice of medicine, and as an industry we lag behind in the day to day innovation seen in most other professions. I am not referring to the latest medical device or minimally invasive procedure. I mean the interaction most patient have with medical care, the physician visit to either report a problem or get feedback on how to fix a problem. That is where we are lacking, but more on that another time. Lets examine the WSJ piece.

The opening salvo of the inflated physician charges are to be expected, to grab the uneducated reader much like an embellished link on a web site looking for screen grabs. Do I really need explain the overhead cost of running a practice, or that authorizations are typically required by insurance companies? Didn’t think so.

While I sympathize with Mr Kessler’s mention of misdiagnoses, I am not sure that the rational response is, not seeking out a better physician, but turning to apps and gadgets for medical answers. While most of the tech mentioned can provide some useful lifestyle information, I am not sure they should be counted on for reliable and meaningful medical insight.

Then we move on to the nirvana of the walk-in clinics, on-line or app based doctor ‘visits’. Again, while a role may exist for these outlets, they have not yet proven themselves to be reliable methods of solving real acute issues.

As a last point, and maybe what I disagree with most, is his final claim on the glory of more information. With the statement “Data, data, data - the more the better” he shows the ignorance shared by most non-physicians. It is not more data that is meaningful. It is the correct data, obtained after deciding what is most appropriate for that specific patients problem, something that can be only achieved with a personal interaction with a trained physician. This is the whole basis for accurate cancer screening, in addition to the basic thinking that should support every test ordered on a patient. More data means more irrelevant data, which can lead to more testing, driving up cost, inconvenience and in a worse case scenario, unintentional harm.

Doctors need to equip their daily activities with better technology, which will certainly help with smarter more efficient care. But leave the practice of medicine to the physicians.