Friday, January 14, 2011

Cyber-Puppeteering on Health IT by Dr. TruthHurts

While the specifics in this Xtranormal video "Dr. TruthHurts" on the Patient Protection and Affordable Care Act (PPACA) might be incorrect, and the political views expressed offensive to some, the scenes of "Dr. A.C.O." using a computer (starting at about time 4:09) might not be far from the future cybernetic "truth" we are headed towards.

While the computer-use scenes are mostly sound-based and somewhat hyperbolic, if physicians are not vigilant and outspoken, I fear the machines -- and their users -- will further become servants of bureaucratic control and of money.

Click to play the YouTube video.

Click image to play video

I also note that the diagram of the healthcare bureaucracy in this cyber-puppeteer video is real:

The coming Health Care Mega-Bureaucracy (click to download PDF from

Somewhere, buried in that morass of healthcare facilitators, are quaint relics of the work of the healthcare enablers such as the doctor-patient relationship, informed consent, and private medical decision-making between physician and patient.

Oh wait...I forgot, there are computers to make the bureaucratic morass all work seamlessly.

-- SS


Anonymous said...

Sadly many doctors find moving the decision making process to someone or something else attractive. The simple act of looking at a patient and asking; what is going on I see X has changed, is beyond their scope of practice.

Many, many years ago I had to take a required physical only to be confronted by a physician who let loose with a tirade of personal insults. Standing up the physician finally looked up from his folder and stated he did not need to see a patient; all he needed were the numbers in the chart.

Unfortunately this scene has been repeated. Equally sad is the blather these doctors are spouting comes from the drug reps. The whole concept of looking at the patient has been swept aside with the concept that I have a number. That number may not make any sense given the patient in front of me, but I have a number.

With doctors being paid to check a box the computer becomes a way not only to increase the number of patients seen, but also maximize income by checking more boxes.

Steve Lucas

InformaticsMD said...


I agree about the deterioration in medical culture. The fact that physicians don't stand up for themselves much against IT personnel, a phenomenon I first observed over a decade ago, is a clear sign the field is in a bad way.

However, "check box" medicine is a trap. It's stressful to those who know better; it's dangerous to those who don't care (and their patients).

Sooner or later, many of the doctors who becomes a checkbox & numbers doc will either burn out and leave medicine in the former case, or become a defendant in the latter case.

Physician dissatisfaction is already high. How much higher can it go before an exodus of the best and brightest is the question.

-- SS

Afraid said...

The style and content of the video are very good; funny, poignant and very effective. More of like stuff should be done.

Also, on checkbox medicine, I'm not sure docs will feel the wrath of liability. The big medical centers have leagues of lawyers to insulate everyone there and big AMCs are likely to increase (and bring the grip of health provider monopoly to more cities)