Why Doctors Hate Their Computers Summary

https://www.newyorker.com/magazine/2018/11/12/why-doctors-hate-their-computers

In the article link listed above, surgeon Atul Gawande describes his frustrations with a recently developed new software which he and many others must adapt to. Initially one might assume this person just isn’t good at using software, like your grandmother trying to send an email. However, professionals in the medical field are typically especially adept at technology, their patients lives depend on their ability to update themselves on the latest development in the industry. That being said, the problem must lie in an inefficient new system.

The earlier stages of the switch to the new software are especially problematic. Firstly, medical professionals in all areas are required to spend a lot of time at training sessions when they could be spending it for their patients, which costs efficiency right off the bat.

Next, as everybody learns how to use the system, multiple problems can occur. It can take hours for somebody new to complete a complicated task, or minutes for one who is experienced in it, so the most obvious option is to get help from the IT department. The system is also new as a software product, new software products contain unknown bugs and glitches. I assume there is a rigorous testing process for any new tech when patients lives are effected by them, still, the software can be found at fault in the early stages. Both of these scenarios contribute to hundreds of tickets flood the IT departments inbox. In response, the hospital hires more IT people to help but ultimately a backlog keeps issues in waiting. Some of these issues can be especially serious in the medical field.

These early problems are expected, with the assumption that after a few months the system will be seen as an improvement. In this case however, even after getting use to the system, Gawande and his colleagues notice setbacks compared to the old software. For example, it added the ability for everyone across the organization to edit the “problem list.” The list use to be a quick way for clinicians to assess their patients at a glance, now it is filled with redundant notes from each person who accesses it. The same diagnosis is listed three times by three different people, long descriptions make it difficult to read the few things that actually matter, all contributing to more inefficient overhead. Furthermore, filling out diagnosis sheets has become more time consuming with the addition of new required fields. Whereas it use to take one click to order a mammogram, now it takes three.

What can be done about these inefficiencies? The article elaborates by explaining the concept of the “tar pit.” This describes a state of software development where a program becomes so large, it must be rigorously defined and spelled out for every specific situation so that it can encompass each scenario the same way. Users find themselves slowed down by these specifics, but cannot escape them, much like a tar pit. The result is that professionals spend so much time working through the system, they spend less time actually doing their jobs.

Software progress trends like these have serious consequences, professionals in this situation are more likely to experience burnout. Burnout is a state of emotional exhaustion, depersonalization, and personal ineffectiveness, this is caused by the pointless bureaucratic work that professionals must endure with their daily career. This eats up much more time than they are willing to give up. In 2014, only a third of physicians stated their work schedule “leaves me enough time for my personal/family life.”

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