Technology Is Transforming the Doctor/Patient Relationship
Extraordinary discoveries and technological breakthroughs have not just tamed once deadly diseases and improved medical outcomes during the last few decades, they have also altered the very foundation of the medical care: the doctor-patient relationship.
As the pace of change only promises to accelerate, the medical community must tend to this most human aspect of medicine to ensure it remains healthy.
Traditionally, a highly trained physician-expert focused on explaining complex medical problems and encouraged patients to accept the prescribed course of treatment.
In recent decades, however, medical schools and hospitals have moved away from this one-sided relationship by training physicians to see the doctor-patient dynamic as a collaboration. We’ve found that the best outcomes often occur when both partners select the therapeutic approach the patient finds best suited them.
This approach has been further galvanized by the rise of the internet and other technologies that have empowered patients to learn far more about their illnesses. Gone are the days when their sole source of information was what their physician told them as they lay on the examination table or sat during sometimes frightening office consultations. Now many who face a serious illness go online and learn about their ailments and potential treatments. This dynamic has been further fueled by the rise of patient portals which can provide raw lab numbers and other data points even before doctors have a chance to see or discuss the results.
Two more forces now promise to further evolve doctor-patient relationships. The first is the explosion of scientific understanding of all aspects of health and disease. There are countless examples that have led to important disease-altering therapies for many cancers, diabetes, heart disease and childhood diseases. Understanding the human genome underlies many of these advances. For example, genetic sequencing now allows medical professionals to identify acute diseases, potential birth defects, and even inform precision medicine and how an individual might respond to different types of treatment.
However, it has often been noted by physicians and patients alike that Dr. Google hasn’t examined the patient and many people tend to focus on the worst scenarios regarding their symptoms. A 2018 survey of 240 family practice physicians found that “97 percent reported that a patient presented to their office with misinformation from an online source.” In addition, 79 percent of the responding physicians “thought the increased availability of medical information online made patients more likely to question their diagnosis or recommendation.”
Technology adds another pressure. While providing some benefits to care, the rise of electronic health records has also made increasing demands on the time and attention of physicians. It is not uncommon for patients to think their doctor is spending more time looking at a screen than listening to them. Given the time constraints, it is not surprising that some doctors might seek to find the quickest way to shut down inquiries they consider off-base.
So now we enter the era of Artificial Intelligence (AI). Without question, AI can help physicians and other health-care providers respond to questions and even improve documentation, allowing more face-to-face time with their patients. This can be pivotal in making sure the doctor-patient relationship continues to be an open, two-way communication: the essential building block of quality care. For all the capacity technology provides to diagnose and treat illness, nothing is more valuable than an accurate medical history and an honest account of what the patient is experiencing and observing regarding their health. One of a physician’s most important skills is the ability to listen to and draw out accurate information from those they are caring for. Unfortunately, another 2018 survey found that most people admit they are not completely forthcoming when discussing their health with doctors.
Indeed, our age of high-tech medicine is making a healthy doctor-patient relationship even more crucial for meeting the central challenge of medicine: providing the right care to the right patient at the right time. This requires physicians to see their relationship with patients as a true partnership, in which the caregiver’s expertise is empowered by the patient’s knowledge of their life experiences and their questions and concerns about what ails them.
I believe that AI can augment the doctor-patient relationship. A physician should never rely on AI to answer patient questions, nor should patients. But it can be an important “first draft” for consideration. Doing so can foster patients’ active participation in their care which can inspire meaningful discussions and new insights. The future of medicine depends as much on this balancing act, this partnership, as it does on the next wondrous breakthrough.
Marschall S. Runge, MD, PhD, is Executive Vice President for Medical Affairs and Dean of the Medical School for the University of Michigan. He serves on the Board of Directors for Eli Lilly and Company.
