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Are Docs Getting a Bum Rap?

November 26, 2014
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Last week, I was listening to the Q&A portion of a panel at the Digital Health Conference in New York with some degree of interest when something caught my attention.

Before I get to that, I’d like to level with you readers. The Q&A portion of a panel at conferences is, by far, my least favorite part of attending these events. It doesn’t matter what event it is because there always seems to be a degree of self-serving taking place. Some of the questions are groan-inducing and some are uncomfortable.

I’m sure we’ve all been there. Someone comes up to the microphone with a thought that probably made more sense in their head than it does in reality. There is typically a lot of rambling, some unsubstantiated assertive statements, and often, not even a question. People often just use the Q&A as an airing of the grievances a la Frank Costanza.

They’re not all bad, though. On occasion, a question will perk my interest and get a legitimate discussion. As stated, this happened last week at the Digital Health Conference. The conference is the annual event of the New York eHealth Collaborative, a collaborative nonprofit that implements statewide health information exchange (HIE).

The panel itself was on big data in healthcare, specifically the integration of genomic and clinical data. After talking about some of the work they were doing in genomic and clinical data, the panelists focused on the technical and operational challenges of integrating genomic and clinical data. They talked about the typical issues that we hear about: data in siloes, the design of systems, unaligned incentives, the lack of an infrastructure, and a fragmented health system.

These are issues that are talked about at-length at every conference, on the real and virtual pages of Healthcare Informatics and any other respectable publication, and in hospitals and health systems across the country. It was standard, if not informative.

It was toward the end that something odd happened. A mini spiel actually caught my attention and got people talking. Someone asked the panelists a question essentially wondering why there was so much physician bashing at digital health conferences. The young woman, who said she was a student, reiterated that many people in her generation were eager to leverage health IT to help healthcare evolve.

“How are you educating physicians and making them your ally rather than the bad guys?” she asked. 

Jonathan Hirsch, one of the panelists and the founder and president of Syapse, a software company that enables providers to deploy precision medicine programs, channeled his inner Sean Maguire and told physicians it wasn’t their fault. “They get a bad rap because physicians are at the leading edge in the adoption curve of many technologies. The problem here is they haven’t been well served. They haven’t been well served by IT. It’s not the physician’s fault, it’s the IT community’s fault,” he said.

Hirsch’s comment warranted a round of applause and a response from an IT person. The response from the IT side was essentially, “When was the last time, doctors came in our door and asked to partner with us.” That comment too warranted a round of applause. It was like a presidential debate where each side applauds their candidate’s comments in an attempt to show the other side who knows what.

I’m not sure what sparked the initial comment. As I recall that panel and look at my notes, I don’t see any physician bashing. Whatever it was, it definitely sparked something. As I walked around the conference hall the rest of the day, I heard and overheard people talking about the back-and-forth that occurred. It was invigorating.

Personally, it made me wonder if more physicians don’t feel this kind of persecution. Maybe they are getting a bad rap. I myself have taken to this space to, more or less, bash physicians. Most recently, I wrote about their refusal to digitally correspond with patients.

Let me be clear, some of the criticisms lobbed at physicians are fair. Just like some of the criticisms lobbed at software companies, IT departments, policymakers and even, the media. When it comes to reinventing healthcare, everyone is accountable for success and failures (as someone was kind enough to tweet me).

However, perhaps some of us are digging in a little bit too hard on physicians. These are people an incredible amount of weight on their back from the transition to EHRs, ICD-10, accountable care, the decreasing amount of help in primary care, the five-minute encounters, and much more. These are people who came to medicine to help, not take on administrative tasks.