Technology takes us away from the bedside—and the very ethos of medicine

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  • Mike Fraumeni says:

    Along with this, isn’t so sad a high level administrator in Ontario’s health care system has to rely on a cancer patient’s death to bring focus to the Ontario Ministry of Health and Long Term Care and Cancer Care Ontario lack of funding for these situations. So sad for Dr. Ralph Meyer and others in this situation, they are simply automatons without much of a voice at all to the Province of Ontario and their beancounters:

    “Laura and her family raised a lot of awareness across the province and the country,” Meyer said. At the time, Ontario Health Minister Eric Hoskins also tweeted his support following a wave of media attention to stem cell treatment access.”

    I mean why does a patient need to raise awareness to the professionals at the Ontario Ministry of Health and Long Term Care and Cancer Care Ontario? What a ridiculous situation that is when someone like Dr. Meyer is admitting he is basically not much of a voice? Very sad.


  • ChaseEverett McMurren says:

    Thanks for your thoughtful piece! I’m grateful that you’ve brought awareness to this important subject.

    Language that reminds practitioners that the person they’re writing about is the point of the note itself can be a powerful way to bring meaning and value to the significant amount of time spent documenting encounters.

    How much extra time does it take to spell out someone’s name in place of “pt”? When we actively name the person whose story we’re describing (filtered and retold, as it may be), I think we are given a brief moment to slow down and remind ourselves who we’re writing about and why we’re writing the note in the first place. If we can compose a note with the intention (and hope) of improving the care (and health!) of the person the note is about–with that person actively in our mind’s eye as we describe their story as we see it–there’s a chance everyone can benefit.

    Of note, I’m increasingly mindful of the possibly ageist implications of beginning a report with a person’s age. People speak of ageism as a final frontier in reducing discrimination, and I’m reminded of the concept of biological vs. chronological age. How helpful is it, really, to report a person’s chronological age, other than for activating a reader or listener’s assumptions of what that age looks like? What if practitioners didn’t need to set the stage with “___ is an 84-year-old lady from ____,” and instead focused on the person and the reason they’ve sought help?

    Ultimately, we all create stories based on the stories we’ve heard already, and it’s impossible to make meaning without calling on what we’ve seen-and-heard in life so far.

    As Sherlock Holmes says in “A Study in Scarlet”:
    Before turning to those moral and mental aspects of the matter which present the greatest difficulties, let the inquirer begin by mastering those more elementary problems. Let him, on meeting a fellow mortal, learn at a glance to distinguish the history of the man, and the trade or profession to which he belongs. Puerile as such an exercise may seem, it sharpens the faculties of observation, and teaches one where to look and what to look for. By a man’s finger-nails, by his coat-sleeve, by his boots, by his trouser-knees, by the callosities of his forefinger and thumb, by his expression, by his shirt-cuffs—by each of these things a man’s calling is plainly revealed. That all united should fail to enlighten the competent inquirer in any case is almost inconceivable.

    While keen deduction (…during clinical rounds, perhaps), can help construct an impression, the risk of losing sight of the person themselves remains present. Assumptions can get us in trouble if the focus is on being clever instead of being curious.

    In any event, the value of simply using a person’s name to keep our attention on them can be a potent change in practice.

    Thanks again! :)

  • Sheila Douglas says:

    This is very insightful, after having been with family members who were treated like a number instead of a human I find this very much the way patients are treated at times. Hopefully Educaters will point out that compassion is a real healer of the spirit, helping then with the healing of the body. Thanks for sharing this read.

  • David Walker says:

    Well said indeed. Removed from the human context, the exercise is intellectually challenging, but so uni-dimensional. Presumably we enter this profession because we are interested in the human interactions and transactions that are so meaningful and helpful to our patients and thus so satisfying to us.

  • Rob Halkes says:

    Interesting, one might ask wether we need to go back to times when the physician “knows it all, sometimes efven already”? Isn’t practice “applied science”? I think both aspects, are crucial: doing a throught analysis in medical terms so as to adhere to medicine insights/values, and interacting/ communicating with the patient to know the patients’ opinioins, context and conditions so as to jointly decide how to apply the medical insights and suggestions. Not to speak indeed about how to bestdo this in the frame of time/costs aspects of medical care. healthcare is devellping and evolving to new formats and staes of care. Let’s take up that challenge?

  • Kirstin Veugelers says:

    I am grateful to read this reflection! As a patient advocate, it is my priority to focus on the human aspect of care, of recognizing the multi-dimensional person that is being treated, so this article really resonates with me.
    As you so insightfully point out, there may be additional factors that influence the best way to administer treatment to the individual. I consider it the highest form of care when a doctor intentionally seeks out that personal information, and demonstrates they have heard that information by using it to inform the most appropriate treatment. Love to witness occasions when this is put into practice!

  • Mark Crawford says:

    “Are you anesthesia?” “No, I’m Mark.” *Awkward pause.* “The appy’s here.”

  • Mike Fraumeni says:

    Great to read that this is front and foremost in the minds of some of our physicians in Canada, very nice. Blends in with what Victor Montori is emphasizing as well albeit with differences between Canadian and American health care structure and culture.

    “He wrote his slim and moving book to “see things as they are,” as George Orwell put it, and what he sees is the ways in which the industrialization of health care, rather than making it more efficient, has instead corrupted the mission of medicine. It has turned doctors and nurses into tools of a profit-seeking machine, “care” into a means to fulfill corporate ends. Montori sees a system filled with “unintentional cruelty” where “care happens almost by mistake.”

  • Mary Gerdt says:

    In an ideal world, the ER would not have been necessary.
    The Woman with the infection could have had a Nurse or Doctor visit at her home. What better place to get to know her Greater Biome? BTW , the Nurse who got told by Doctor to replace the wheels will never forget that snipe comment. As a nurse, juggling patients, families, Management and Doctors, if they say bed 15 needs a PT consult, it’s ok to just write the order. In Fact, why Did the Nurse have to tell you what to order, anyway? Didn’t You Observe Your Patient Walk? Even from the Doorway?


Benjamin Chin-Yee


Benjamin Chin-Yee is a hematology resident and postdoctoral fellow at the Rotman Institute for Philosophy, Western University.

Wayne Gold


Wayne L. Gold is an internist and infectious diseases specialist at University Health Network/Sinai Health System where he also serves as Deputy Physician-in-Chief, Education.

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