Digital Detachment and the Radiologist

August 22, 2014

Will technology make the radiologist obsolete one day?

As I stroll through the area where the techs and transporters hang out between patients, I am struck by the contemplative, almost prayerful way everyone is gazing at their hands, or more precisely, their smart phones. We hear more and more often about children losing the ability to interact with others because of their fixation on digital devices. It can be hard to pry a grandchild from his electronic tablet to go outside and play. I frequently find myself losing out to streaming movies, cartoons or some online game in this regard.

Indeed, as a society we are becoming more comfortable with texting or emailing than with person to person communication. Most of us have had some unpleasant experiences with the lack of a “tone font” or an unintended group message. Nowadays, I am trying to pick up the phone and communicate directly if I am not able to communicate face-to-face. It leads to less mistakes and better understanding.[[{"type":"media","view_mode":"media_crop","fid":"27095","attributes":{"alt":"","class":"media-image media-image-right","id":"media_crop_2906310804081","media_crop_h":"0","media_crop_image_style":"-1","media_crop_instance":"2603","media_crop_rotate":"0","media_crop_scale_h":"0","media_crop_scale_w":"0","media_crop_w":"0","media_crop_x":"0","media_crop_y":"0","style":"height: 100px; width: 150px; border-width: 0px; border-style: solid; margin: 1px; float: right;","title":"","typeof":"foaf:Image"}}]]

As radiologists we have become masters (or possibly slaves) of the digital world. Our work can be done from almost anywhere. There are weekends on call when I never set foot in the hospital. Unless there is a procedure, I don’t need to. My speech recognition generated reports are so formatted and filled with auto-texts that they seem totally machine generated with no personality or style. The need to capture every observation in an obstetrical ultrasound in order to bill for a complete rather than limited examination has lead to a standard plug-in report that could come from a technologist generating a standard report from their findings and measurements or a robot.

Radiologists along with the rest of society are becoming digitally detached and the more detached we are, the harder it is to assert our value. Our virtual omnipresence and digital efficiency may have sown the seeds of our destruction. Have you noticed how often websites offer live chats lately? I believe that while this is a very efficient way to communicate, it also removes the barriers and stigma of language and ethnicity from the exchange of information. The frustration of dealing with someone in a phone bank in India is gone. It will be just that easy to replace us someday.

What do we offer to counter this? Radiology services are being effectively commoditized. I admire the efforts to educate the public and put our best face forward to patients and referring physicians. Unfortunately, in today’s busy practice it is rarely practical to speak directly with patients on a routine basis. I have found that my pace has gradually increased to cope with peak work flow times and I am unable to slow the pace even when there is a lull in the action.

Over the years it has been difficult to earn the respect of my medical colleagues even to the extent on occasion of having to assert that I am a real doctor not a technologist. I suspect that as medicine evolves or devolves (depending on your point of view) we may, indeed, become essentially technologists. One day we may even become an app on a digital device - the ultimate in digital detachment.