Technology and the Doctor-Patient Relationship

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About the Book

Medicine is an ancient profession that advances as each generation of practitioners passes it down. It remains a distinguished, flawed and rewarding vocation—but it may be coming to an end as we know it.
Computer algorithms promise patients better access, safer therapies and more predictable outcomes. Technology reduces costs, helps design more effective and personalized treatments and diminishes fraud and waste. Balanced against these developments is the risk that medical professionals will forget that their primary responsibility is to their patients, not to a template of care.
Written for anyone who has considered a career in health care—and for any patient who has had an office visit where a provider spent more time with data-entry than with them—this book weighs the benefits of emerging technologies against the limitations of traditional systems to envision a future where both doctors and patients are better-informed consumers of health care tools.

About the Author(s)

D.C. Lozar, M.D., worked for the National Institute for Health (N.I.H.) in neurobiology research, at Columbus Hospital in downtown Chicago as a surgical resident, and at Cook County in trauma surgery before pursuing family practice and spending the last twenty years honing his skills as a physician in primary care. For more information, visit his website at www.dclozar.com. He lives in Carlsbad, California.
Elaine A. Moore has worked in hospital laboratories for more than 30 years, primarily in immunohematology and toxicology. She is a freelance medical writer and laboratory consultant. For more information, visit her website at www.elaine-moore.com. She lives in Sedalia, Colorado.

Bibliographic Details

D.C. Lozar, M.D.. Series Editor Elaine A. Moore
Format: softcover (6 x 9)
Pages: 260
Bibliographic Info: notes, bibliography, index
Copyright Date: 2019
pISBN: 978-1-4766-7520-6
eISBN: 978-1-4766-3744-0
Imprint: McFarland
Series: McFarland Health Topics

Table of Contents

Author’s Note xii
Preface 1
Introduction 3
One. Buck Rogers Medicine (Utopia) 7
The Electronic Medical Record 7 • Rebooting Humanity 13 •
Challenging Evolutionary Barriers 15 • Augmentation and
Wearable 16 • My Thoughts 17 • Reality Check 18
Two. George Orwell Medicine (Dystopia) 20
We Are a Trade, Not a Business 20 • Censorship—Net
Neutrality 25 • Freedom 26 • Universal Health
Identifier 27 • My Thoughts 28 • Reality Check 30
Three. Frontier Medicine (Old School) 31
Cowboy Charlie 31 • Tragedy Loves Ignorance 35 • Hospitals
Built on Bedlam 37 • A Doctor’s Doctor 39 • Sawbones 41 • Apothecaries 42 • The Nightingale’s Song 44 • My Thoughts 45 • Bringing Us Up to Date 47
Four. Beam Me Up, Scotty (Telemedicine) 49
Unexpected Consequences 49 • Luddites 52 • Taylorism 53 •
Dumb and Dumber 55 • My Thoughts 57 • Prescribing Caution 60
Five. The Healing Touch (Origin Story) 61
Lifting the Hood 61 • The Power of Proximity 63 • The Death
of the Physical Exam 65 • Case Studies 65 • Appearance
Is More Than Skin Deep 69 • You Can’t Arrest Me 70
Six. Go Gently into That Good Night (Death) 72
Waiting for Godot/Death 72 • Accepting Death 74 •
Immortality 76 • Death Is Not Our Enemy 78 • My Thoughts 79 • A Good Death 81 Seven. Lawyers, Doctors and Lobbyists, Oh My (Mala Praxis) 82
Mala Praxis 82 • Sharks in the Water 84 • Bad Medicine 85 •
Money Talks, Doctors Walk 87 • Defending the Castle 88 •
Politics Is a Shell Game 91 • My Thoughts 92 • Case Closed 94
Eight. Medicine Is Dirty (Don’t Bring It Home) 96
The Training Gauntlet 96 • Dividing Up the Family 99 • Testing
the Monkey 100 • Cannon Fodder 103 • Quitting Life 106 •
The Sterile Glass Ceiling 107 • Mamas, Don’t Let Your Babies
Grow Up to Be Doctors 108 • My Thoughts 109 •
The ­Not-So-Perfect Match 111 • Technology May Clean Up
Medicine 112
Nine. It’s The Money, Stupid (Terminal Economics) 113
How Much Is Your Life Worth? 113 • The Maintenance
of Certification (MOC) Scam 116 • Fraudulent Billing 118 •
Big Pharma, Little Ethics 119 • Unions 120 • My Thoughts 123 • Prove It 125
Ten. We’re Only Human (That’s the Point) 127
Trigger Warning 127 • Intersubjective Angst 128 • Dataism
Versus Vitalism 130 • Calculating Compliance 133 •
Epicureanism 134 • My Thoughts 135 • The Invisible World 137
Eleven. The Librarians (Custodians of Health) 139
The Good Librarian 139 • Metaphors Are Magic 141 • You’ve
Got to Have Heart 141 • Vintage Cars 144 • Minions and
Mood 145 • The ­Never-Ending Story 147 • It’s Only Skin
Deep 148 • The Endocrine Economy 149 • My Thoughts 152 • Trust Your Librarian 156
Twelve. The Altered Mind of a Physician (Evolution?) 157
Losing Our Minds 157 • Neuroplasticity 159 • There’s a Hole
in My Bucket, Dear ELIZA 162 • Deskilled Doctors 164 • Why
Can’t I Open the Black Box? 167 • My Thoughts 169 • Paging:
Doctor Watson 171
Thirteen. We Are Not Alone (It’s Called a Planet) 173
Socialized Medicine—It Works for Them 173 • Tiered Health
System 174 • Global United Health Care 175 • My Thoughts 178 • What Next? 180
Fourteen. The Brave New World (Is Here) 181
Invasion of the Doctor Snatchers 181 • Artificial Emotional
Intelligence 183 • That Epigenetic Smile 185 • Waiter,
There’s a Cyborg in My Soup 187 • My Thoughts 189 •
Datopia 191
Fifteen. Doctor Tomorrow (What’s Next?) 193
The M in D Is a Terrible Thing to Waste 193 • A ­Hands-Free
Physical Exam 195 • AI-Run Nursing Homes 196 • AI, Dearest 198 • My Final Thoughts 200 • Dr. Laicifitra 202
Addendum 205
Chapter Notes 209
Bibliography 223
Index 241