The Future of Diagnostic Medicine

We have been inundated with information citing the too-high and rising cost of medical care, the inaccessibility of care, the inefficiency of care, the poorly managed pool of liability issues in medicine, the lack of adequate communication among physicians and hospitals, and… shall I go on? The list is longer, as you are painfully aware. But there has been little public discussion of how rapidly developing medical developments and best practice information have gone far beyond what the individual practitioner can optimally assimilate and manage.

It has been widely acknowledged that, no matter how smart a doc is, or how well trained or how hard-working, things have gotten to the point where no one can know everything we need to know. Not even in a limited specialty. Not even in a niche. And certainly no one can stay on top of the 1,500 (!) medical journal articles that the Library of Congress takes in each day. That’s right, each day.

Docs are becoming grudgingly more accustomed to using computers/tablets to keep our records, our billing, and databases for things like the PDR. And don’t start with me about how well that’s all working out. Like a misfiring V-8 that needs some new spark plugs. But there clearly is another function that is quietly becoming more used and more necessary.

That is the use of diagnostic software, of which there is now a proliferation. If you are not familiar with this area yet, just Google it. We are aware of how the recent and similar development of pilot-like checklists are reducing mistakes in ICUs and CCUs.

Traditionally, when stumped, docs refer to a specialist with more knowledge and experience in a narrower focused area. But all will admit, if you think about our experiences in this area, that this is another part of our system that does not work very well. Hand-offs tend to increase error and communication is often hit or miss, I am sorry to say, the phone, the net, and texting notwithstanding.

And even if the process works, it is slow, expensive, and inconvenient for all concerned. So being able to delve more deeply into an up-to-date hand-held algorithm to make us more accurate, reduce error, save time and money, is very appealing. Especially for the other doc, some cynics might add.

There is a developing alternative idea that is a bit more comfortable for we of slower to adjust, more hide-bound bents. That is a newish site called CrowdMed.com. I have no ties to this operation I should add, but it does hold some promise.

A doc, or a patient with a diagnostic conundrum, inputs the pertinent data, pays for whatever “level” of activity requested, and the case goes out to a web of interested docs. It’s like a CPC times 100. Any docs who have an insight can opt in and they will be remunerated on the basis of how useful their ideas are.

The anecdotal track record so far is positive. Some patients who have been to many docs, over time, having spent beaucoups bucks, and having been frustrated, have come away with previously unattained diagnoses and recommendations.

The brouhaha about cost, access, and quality arising from our chaotic jumble of healthcare institutions needs to be resolved. Meanwhile, docs can do a better job of helping our patients directly by investigating and using these new diagnostic tools available through the miracles that are the computer and the Internet.