Monday, August 30, 2010

Health IT Personnel - Aliens in Healthcare?

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Sept. 1

Important note
- it appears the survey results referenced below were contaminated by activists who could not allow this survey to occur unmolested. From HIStalk, the source of the survey, a site ordinarily read by a relatively narrow health IT-involved audience:

If you’ve been following the current poll and comments on Ed Marx’s Blessing of the Hands post, you may wonder why the comments suddenly turned ugly. An atheist blogger linked to it and his followers dropped by to vote and opine. Since the point was to find out what industry people think, here’s the stat that counts: the poll was running 50-50 when it was just real readers voting.

The Aug. 30 post below may reflect sabotage of the poll.

-- SS

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It is commonly accepted that respect for patient's cultural, ethical and religious views must be taken into account in their care. In fact, that understanding and respect for those values are critical.

I think it also fair to say that many if not most practitioners of medicine also believe in a force higher than themselves, even if not formally involved in organized religion.

I, in fact, minored in the history of religion in college. One of the most valuable pre-med courses I participated in concerned religious beliefs about illness, death and dying.

In a remarkable survey at the anonymous HIStalk health IT industry/rumor blog site, however, these views seem alien to many of the HIT personnel who frequent that site.

As of this time (8/3/2010, 10:15 AM EST) the tally of responses to this sidebar question at that site in part created after reactions to a CIO essay on religious values here:

Should hospital IT employees be expected to have a higher level of compassion and spiritual beliefs than their counterparts in other industries?

are as follows:

No - 90% (519 votes)
Yes - 10% (59 votes)

While informal, I'd say a red flag is raised. These results go against mainstream values in medicine, and the values of our American culture and heritage at large.

Some of the comments in particular were revealing of contempt for these values and arrogant certitude typical of the IT field in general:

Example 1:

Higher level of compassion and sense of responsibility yes, spiritual beliefs - no. Relying on belief in many cases may cause more harm than good. Of course, some types of spiritual beliefs lead to heightened sense of responsibility (like the one Ed Marx has demonstrated), but not all, and heightened sense of responsibility is not dependent on one's spiritual beliefs.

Example 2:

I understand the meaning of the word COMPASSION, as the expression of sympathy for a separate person in different circucmstances. I expect that understanding is the common on. I have some ideas on how it works conceptually, and I expect I could find common ground with a great many people on that subject. I understand the meaning of the term SPIRITUAL BELIEFS, as the holding of a baseless conviction as to the existence of disembodied consciousness. I am confident that those who have them would express them as convictions or the equivalent of convictions, that they are unable to point to evidence supporting their convictions, would agree their beliefs entail disembodied consciousness, but would prefer to put it some other way. I have no understanding at all of how a disembodied consciousness would be able to exert influence on embodied third parties, or how a person who believes in the existence of disembodied consciousness might explain it. Perhaps I am missing something obvious. If so, I would appreciate someone explaining it here.

Example 3:

I agree ... I'm very tired of this idea that only religious people can be moral or compassionate or sensitive. It's simply not true. And competence, the most important quality in an IT person, has absolutely no connection to religiosity.

Example 4:

Good grief, I hope I don't get sick and then have to go to a hospital full of staff that think that their religious bend can help heal people. Annointing oil? What a bunch of mumbo-jumbo.

Example 5:

Lol, this ceremony probably makes the chaplains maintain a sense of importance. Sorry to puncture the bubble, but your magic oil and mumbo jumbo belong to the first century desert tribes, not a 21rst century hospital.

While people in healthcare and anywhere else in this country are free to believe in God or not, people in healthcare should be sympathetic to those who do, no matter what their own personal feelings.

These comments and the survey results in general, I fear, show contempt for religious values and for those who hold them.

There's a comment about these folks actually having a cybernetic religion of sorts:

You folks *do* have a religion. You worship machines.

I agree with that assessment.

Others in a Middle Eastern oil-producing country I once visited to implement IT for care improvement of children with birth defects, in part out of interest in personally living by example and promoting cultural and religious reconciliation, have a different term for that particular religion: idolatry.

I can't say I disagree with that, either.

"Compassion" and "contempt" may both begin with the letter "c", but are essentially incompatible.

Those with contempt for common patient values such as religious beliefs should not be working on tools critical for safe care delivery, in my opinion.

In fact, I'd rather have this type of arrogant, contemptuous healthcare facilitator not working in healthcare at all.

-- SS

8 comments:

APeticola said...

Can't agree with you at all here, Scot. Had the commenters not been pro-responsibility and compassion, I would agree, but comments about the harms of religion or its (in their opinion) foolishness, not TO sick people or workers at a stressful time (which I doubt most of these people would choose to make out of respect), but in a separate forum, is quite in line. Your accusing these people of therefore idolatrously worshiping machinery is over the top.

Yes, some of the comments may have been a little hot and injudicious, BUT the column that suggested a "blessing of the hands" ritual in the workplace was itself over-the-top religious, all about the holy and sacred, and I think naturally provoked such reactions. The comments weren't more out-of-line than the original, well-meant but overly religious, attitude of the CIO.

I too would prefer to avoid religiosity in my caretakers. As well, while I have sometimes seen sick people find comfort in religion, I've also seen religious beliefs cause a lot of misery. In my own family, my mother was a strong Catholic. We thought that might help her at time of death. Instead as she became delirious, strong and very negative religious fears that made her last hours worse surfaced.

My brother, who died recently, was negatively impacted and annoyed (although in a minor way) when his surgeon chose to express his strong religious beliefs to him post-surgery. It was well-meant and I was not as bothered as my brother, but it was not helpful to him at a time he was terribly physically sick, and I think was inappropriate.

I agree with you about many things on healthcare IT and why it is way offtrack. This includes testing of healthcare IT, issues around non-disclosure of flaws, involvement of people who actually know about medicine and medical informatics, etc., and I highly value your opinions. But in this case I think YOU need more respect for unbelievers.

MedInformaticsMD said...

I am sorry to hear about your brother.

I am not advocating anyone inflict their views on others, period.

The issue is not about respect for unbelievers. It's about IT personnel's respect or lack thereof for patients and their beliefs (and this also applies to clinicians), whatever those might be, whether religious or not.

I believe for clinicians, respect for their patients' cultural and religious beliefs is critical. It's knowledge (from historical courses in my case) that helped me be a better physician with people to whom religion was important - and also helped me work in a religious land where people of my "tribe" have rarely ventured. That does not mean imposition of one's personal beliefs upon patients.

I found the comments left by a number of people not just injudicious, but outrageous and disrespectful in the extreme. Also lacking were any responses pointing that out, at the time I viewed the comments.

I have written before that IT has become a quasi-religion. E.g., see "IT Religion and Windows 7 God Mode."

There are rampant, near unshakable, irrational beliefs that these devices in their present form can create revolutionary improvements in medicine, with a scant evidence base and growing evidence base to the contrary.

That few in IT seem to seriously care about the possibility of wasted resources better spent elsewhere in healthcare, and indeed in the capacity of these devices to harm people, strikes me as callous in the extreme. In that sense 'idolatry', I believe, is an appropriate term.

-- SS

MedInformaticsMD said...

p.s. see my post on the original CIO essay here. I had my own angle of critique.

Anonymous said...

Compassion yes, spiritual no. BUT, as opined recently in the NY Times Op Ed, IT has become a religion for those immersed and seed no way other than their own, fanatically. It is this fanatacism which equates to arrogance that retards the industry and its products. The IT spirituals are blinded by their intense observance of the new religion, as opined.

Live it or Live with it said...

I like to call a spade a spade, and an 'appelite' and 'appelite.'

(Appleite , albeit spelled 'correctly' leads to confusion, so I prefer Appelite. Appleite however may work better as may be confused with Apple-elite, generally in the same vein. I believe Appelite also may protect me from a spurious suit that would be intended to use trademark law as a free speech impediment)

MedInformaticsMD said...

Live it or Live with it.

I'm not sure what point you are trying to make.

-- SS

MedInformaticsMD said...

See the new preface to this post.

It appears the poll was sabotaged, in the ultimate act of disrespect for others' views.

-- SS

Live it or live with it said...

My obtuse point was that the techies worship at the feet of the captains of the tech industry. They may simply not be able to understand a higher power not manmade.

I was that way once too, and an experience in medicine gave me respect for the mystery.

Sorry for the distraction.