About
By Amy Fahey
A little over a year ago, I took my aged father for a specialist visit. The appointment, which I still recall with painful clarity, put me in mind of the Anglo-Saxon poem known simply as "The Ruin." The manuscript is damaged, so what remains is itself a kind of ruin, a meditation on former splendor contrasted with brokenness and fragmentation. It struck me then, as it does now, as a fitting metaphor for the current state of healthcare in our nation.
The receptionist hands me a tablet and stylus and tells me to register my father. There are a series of questions on the screen, all related to his bladder. In addition to recently losing his vision, my father is now hard of hearing, so I begin: "How many times a day do you have to." But I stop myself as I realize how embarrassing, even dehumanizing, this will be in a crowded waiting room. My father waves his hand in the air and says with his characteristic midwestern bluntness, "Just answer down the middle for all of them. They don't read that sh*t anyway."
The wife of a couple nearby cups her hand to her mouth in a repressed giggle. Her husband turns to her and says sharply: "Well, he's right."
When we make it to the appointment room, the good doctor (I have heard from my father that he is a good man, a Catholic) breezes in with his own hand-held screen, followed by a young woman in a white coat, who presumably is following the doctor on his rounds to learn the art of healing. He begins scrolling rapidly, reviewing my father's records.
Meanwhile my father, summoning up all his courage, launches into a well-rehearsed declaration of independence: "I'm not getting any shots today. I don't want any more of that crap put into my body. I've had enough chemicals – they've totally messed up my system."
I'm sure the doctor listened attentively. But I'm also sure his mind was working – working fast. It had to: as he told us, my father was one of seventy patients he would see that day.
I did rapid calculations. Say the doctor arrived at the clinic at 7:00 am and didn't leave until 6:00 pm, with a break somewhere to eat or to discuss a patient's clinical notes with that young woman, or to voice-to-text those clinical notes or even just to relieve himself. That would mean an average of about eight minutes per patient.
My father's weeks of agonizing anticipation, reduced to an eight-minute appointment.
Still, my father hands the doctor one of his favorite cigars: a Rocky Patel Decade. The doctor is effusive in his thanks. Decades, he says, are his favorite too. He is golfing later that week and will smoke it then. The good doctor then simply says, "Your numbers have been coming down. We'll give you a break and reevaluate." And that is that.
I think it's too generous to say that American healthcare is at a crossroads. It is, like the once-glorious city in Roman Britain contemplated by that anonymous Anglo-Saxon poet a millennium ago, in ruins.
Fears that AI might depersonalize healthcare seem to have missed the glaring reality that healthcare has been increasingly depersonalized for years now. When was the last time a doctor spent more time looking at you than at a screen? Who hasn't had the experience of feeling like the doctor is just one Google search ahead of you (or sometimes behind) in diagnosing or determining treatment options?
I'm not suggesting there aren't excellent, dedicated, and humane people in the medical profession. There are, and I've been blessed to know some of them. Yet even as studies warn us of the "cognitive overload" of overworked medical personnel, and prognosticators predict the "cognitive debt" AI will usher in, it seems obvious that both overload and debt have already crossed the threshold of our clinics and hospitals. As in education, COVID only exposed and accelerated a problem that was already there.
Yet there are signs of hope. For several years, my family and I have belonged to a Christian health share, an alternative to conventional insurance ...
A little over a year ago, I took my aged father for a specialist visit. The appointment, which I still recall with painful clarity, put me in mind of the Anglo-Saxon poem known simply as "The Ruin." The manuscript is damaged, so what remains is itself a kind of ruin, a meditation on former splendor contrasted with brokenness and fragmentation. It struck me then, as it does now, as a fitting metaphor for the current state of healthcare in our nation.
The receptionist hands me a tablet and stylus and tells me to register my father. There are a series of questions on the screen, all related to his bladder. In addition to recently losing his vision, my father is now hard of hearing, so I begin: "How many times a day do you have to." But I stop myself as I realize how embarrassing, even dehumanizing, this will be in a crowded waiting room. My father waves his hand in the air and says with his characteristic midwestern bluntness, "Just answer down the middle for all of them. They don't read that sh*t anyway."
The wife of a couple nearby cups her hand to her mouth in a repressed giggle. Her husband turns to her and says sharply: "Well, he's right."
When we make it to the appointment room, the good doctor (I have heard from my father that he is a good man, a Catholic) breezes in with his own hand-held screen, followed by a young woman in a white coat, who presumably is following the doctor on his rounds to learn the art of healing. He begins scrolling rapidly, reviewing my father's records.
Meanwhile my father, summoning up all his courage, launches into a well-rehearsed declaration of independence: "I'm not getting any shots today. I don't want any more of that crap put into my body. I've had enough chemicals – they've totally messed up my system."
I'm sure the doctor listened attentively. But I'm also sure his mind was working – working fast. It had to: as he told us, my father was one of seventy patients he would see that day.
I did rapid calculations. Say the doctor arrived at the clinic at 7:00 am and didn't leave until 6:00 pm, with a break somewhere to eat or to discuss a patient's clinical notes with that young woman, or to voice-to-text those clinical notes or even just to relieve himself. That would mean an average of about eight minutes per patient.
My father's weeks of agonizing anticipation, reduced to an eight-minute appointment.
Still, my father hands the doctor one of his favorite cigars: a Rocky Patel Decade. The doctor is effusive in his thanks. Decades, he says, are his favorite too. He is golfing later that week and will smoke it then. The good doctor then simply says, "Your numbers have been coming down. We'll give you a break and reevaluate." And that is that.
I think it's too generous to say that American healthcare is at a crossroads. It is, like the once-glorious city in Roman Britain contemplated by that anonymous Anglo-Saxon poet a millennium ago, in ruins.
Fears that AI might depersonalize healthcare seem to have missed the glaring reality that healthcare has been increasingly depersonalized for years now. When was the last time a doctor spent more time looking at you than at a screen? Who hasn't had the experience of feeling like the doctor is just one Google search ahead of you (or sometimes behind) in diagnosing or determining treatment options?
I'm not suggesting there aren't excellent, dedicated, and humane people in the medical profession. There are, and I've been blessed to know some of them. Yet even as studies warn us of the "cognitive overload" of overworked medical personnel, and prognosticators predict the "cognitive debt" AI will usher in, it seems obvious that both overload and debt have already crossed the threshold of our clinics and hospitals. As in education, COVID only exposed and accelerated a problem that was already there.
Yet there are signs of hope. For several years, my family and I have belonged to a Christian health share, an alternative to conventional insurance ...