At times in my career as a neuroradiologist and clinical informaticist, you might say I’ve bordered on technophilia. Like Mikey, the little boy from the Life Cereal Commercials, I’d eat/try/use anything new, bright, or shiny. But I’m here to confess. I’ve come to realize that with the opportunities of innovation comes responsibility. Technology has a somewhat insidious effect that may not be fully recognized.
Take the role social media played in the recent events in France as one example. In an excellent essay entitled “Why They Hate Us,” Harvard Law Professor Cass Sunstein notes terrorists do not come from the poor, disaffected or uneducated. Rather, more typically tendencies become hardened beliefs through a process of group polarization. Repeated interactions with other like-minded individuals may move the individual’s belief system from moderate to extreme. Facebook and other social, scalable, networking platforms enable these conversions to reach a tipping point. Instead of 10 people converting to extremism, we have 10,000. In another example more familiar to Americans, look at our political parties. The Internet makes it all too easy to surround yourself with individuals sympathetic to your views. With little input from opposing positions, reasonable proposals become ever more extreme. Now it seems we have ineffectual leadership from both parties, rabid radicals on both sides unable to relate to the real silent majority.
When I look at my space, healthcare, there has been a constant erosion of the more humanistic aspects of care for the promise of technological cures. In America we are all in some sense coin operated. Companies innovate because our system rewards progress. Specialists, including my own area, radiology, are paid at 2-3 times that of primary care providers. Based on hourly reimbursement, talking to patients may better be thought of as charity. And yet, from my experience, you’d be amazed how many expensive tests could be avoided by someone taking the time to ask the right questions. Many of the highly compensated “cures,” from high-dollar sleeping pills to chemotherapy offer negligible improvements in quality of life.
Many of us went into healthcare because of its unique mix between spiritual advisor and scientist. There aren’t many other professions where people will so intimately tell you their problems in hopes that you can help them. I’m just wondering if we need a thoughtful pause before innovating—a little less emphasis on cures, on healthcare’s technical aspects, and a little more value placed on care. Technology isn’t inherently evil. But, as we’ve seen with the terrorists in France, it does present opportunities for unintended consequences.