Vice Chair & Professor of Medicine, UNC | Balanced healthcare perspectives
So much of what we healthcare workers do is “utterly banal and pointless.” Physicians and APPs must process (and often sign) countless notifications, much of it junk and nonsense. Inpatient and OR nurses must document endlessly, including many things that no one will ever read. Schedulers still often ask each patient if they’ve traveled out of the country or been exposed to anyone with COVID in the past 14 days. Front desk staff typically verify insurance and demographic information at each and every visit, even when the patient was just seen. We all hope that AI will magically eliminate all this drudgery. But, as Peter Druker famously said, "There is nothing quite so useless as doing with great efficiency something that should not be done at all.”
It sounds like a problem with healthcare policy or regulation. Who and what can possibly influence positive change?
This reminds me of Bertrand Russell's definition of work in his famous essay 𝐼𝑛 𝑃𝑟𝑎𝑖𝑠𝑒 𝑜𝑓 𝐼𝑑𝑙𝑒𝑛𝑒𝑠𝑠: "𝐅𝐢𝐫𝐬𝐭 𝐨𝐟 𝐚𝐥𝐥: 𝐰𝐡𝐚𝐭 𝐢𝐬 𝐰𝐨𝐫𝐤? 𝐖𝐨𝐫𝐤 𝐢𝐬 𝐨𝐟 𝐭𝐰𝐨 𝐤𝐢𝐧𝐝𝐬: 𝐟𝐢𝐫𝐬𝐭, 𝐚𝐥𝐭𝐞𝐫𝐢𝐧𝐠 𝐭𝐡𝐞 𝐩𝐨𝐬𝐢𝐭𝐢𝐨𝐧 𝐨𝐟 𝐦𝐚𝐭𝐭𝐞𝐫 𝐚𝐭 𝐨𝐫 𝐧𝐞𝐚𝐫 𝐭𝐡𝐞 𝐞𝐚𝐫𝐭𝐡’𝐬 𝐬𝐮𝐫𝐟𝐚𝐜𝐞 𝐫𝐞𝐥𝐚𝐭𝐢𝐯𝐞𝐥𝐲 𝐭𝐨 𝐨𝐭𝐡𝐞𝐫 𝐬𝐮𝐜𝐡 𝐦𝐚𝐭𝐭𝐞𝐫; 𝐬𝐞𝐜𝐨𝐧𝐝, 𝐭𝐞𝐥𝐥𝐢𝐧𝐠 𝐨𝐭𝐡𝐞𝐫 𝐩𝐞𝐨𝐩𝐥𝐞 𝐭𝐨 𝐝𝐨 𝐬𝐨." As electrons constitute matter too, the statement requires no modification for the modern era. https://harpers.org/archive/1932/10/in-praise-of-idleness/
Spencer Dorn, should systems be reviewed more frequently to remove redundant or obsolete processes, or would that create too much bureaucracy? Should we instead focus on using AI to augment this banal and pointless work? What are your thoughts on short vs. long-term improvements?
FACTS
I still feel like a data entry clerk every time I am in clinic. Sad state of affairs. Yet I do have hope for the future as there is promise that the right technology stack and workflow redesign could improve the care delivery experience. That being said, it will take leadership, engagement and commitment from physicians and clinicians like ourselves to make it right. Non-clinical folks need our help with that.
Do you think this bureaucratic nonsense comes from within or without? #government
Love this tweet and couldn't agree more. Physicians and nurses are the most expensive data entry clerks the world could ever imagine
Mindless drugery should be automated. But this by itself does not mean AI can be trusted to take over (any part) of an expert's work. Is it "mindless"? Fable of "where to put the X". Thomas Edison visited Henry Ford at his factory, which was having some kind of difficulty. Ford asked Edison if he could help identify the problem area. Edison walked up to a wall of boilerplate and made a small X in chalk on one of the plates. Ford was thrilled, and told him to send an invoice. The bill arrived, for $10,000. Ford asked for a breakdown. Edison sent another invoice, indicating a $1 charge for marking the wall with an X, and $9,999 for knowing where to put it.
“Greater than 10 pound weight loss in the last 30 days?” asked the Medical assistant. “For our 8-day old newborn with a birthweight of 6 lbs 8 oz?” I replied. “We’re just told to ask the questions sir….” Ridiculous questions and ridiculous inputs into the EHR on a daily basis at a busy Pediatrics practice. No value. Never to be reviewed. Never to add value.
Chair, Non-Labor Governance Committee, Allina Health | Senior Leadership Team, Orthopedics, Allina Health | Entrepreneur | Founder | Shoulder & Elbow Surgeon
3wAlthough like Eve Cunningham MD MBA I am cautiously optimistic with respect to the power of well-designed, appropriately scoped AI to alleviate some of the drudgery that Spencer Dorn articulates, I am also reminded of another poignant statement - this one by author Joanna Maciejewska: “You know what the biggest problem with pushing all things AI is? Wrong direction. I want AI to do my laundry and dishes so that I can do art and writing, not for AI to do my art and writing so that I can do my laundry and dishes.” Direction matters.