Analog Discipline


DisciplineThis story by Iltifat Hussain over at iMedicalApps is worth a peek.  Apparently he had given his medical student brother an iPad for his clinical clerkships.  He went on to receive an unfavorable evaluation by an attending for being ‘too dependent on his iPad during rounds.’

I wonder what this attending was trying to teach him.

I suspect he comes from a generation when doctors knew everything.  Literally.  There was a time when a doctor could learn the medical corpus in two years of preclinical study.  Not anymore.  Maybe someone should remind this attending that the ability to access networked intelligence will replace the laundry list memorization that defined his generation.

While my technoutopian bias has me putting all of this on the shoulders of the attending, I wonder if Iltifat’s brother has any accountability in this case.  The best clinicians are sensitive to their surroundings.  They have a kind of emotional intelligence that allows for adjustment on the fly.

How does this relate to technology?

I like to think that I’m sensitive to the patients around me.  As a pediatrician I encounter grandmothers who insist that anything short of blinkless eye-lock during conversation is a sign of disrespect.  Millennial moms, on the other hand, are more tolerant of dual tasking and the third screen.  The way I talk with a patient surrogate and engage with my EMR or iPhone is absolutely different depending upon the family in front of me.  We have to understand who’s around us and how they may respond to our tools.  I like to think of this ability to intentionally adjust as medical mindfulnessan especially critical literacy for the doctor of the information age.  There’s a time to touch and a time to type.

If you’re not in tune with your immediate surroundings you may feel the sting of smart phone attribution error.  This is when an uninformed observer makes assumptions about what you’re doing with your device.  While medical professionals such as this attending have a responsibility to understand and accept the place of tablets in the modern medical workspace, the digital physician has some responsibility to understand how he’s perceived.  When the observer is a patient, the responsibility is greater.  Every patient encounter should begin with an explanation of what we’re doing, or not doing, with our technology.

In the end the students like Iltifat’s brother are going to have to figure out how to help the world around them adjust to their new mobile tools.  There are few to help them navigate medicine’s shifting ground.