The Real Fantasy Of Star Trek Medicine: Doctors Without An Administrative Burden
One of my favorite summer activities is watching reruns of Star Trek Next Generation. It’s become somewhat of a summer tradition in my family the last few summers. Having become trekkies themselves, my kids were able to very much enjoy the recent movie, and get the history and lore behind it.
The longevity of the Star Trek enterprise is fascinating. Decades after it’s first launch, it still captures the imagination of inquiring minds and still provides endless hours of entertainment to viewers of all ages.
Even more amazing than the longevity of it’s run is the technology it represents. When the show first debuted, the sci fi components seemed truly out of reach. Today, much of the technology in the new movie and even some of the older shows doesn’t seem that implausible, especially when it comes to health.
Early Trek was a preview of our current Health 2.0 world. When first portrayed, that was not a concept any of us could grasp. Think about it. In the original series, and continuing through to the latest movie, they used communicators in high tech ways with online computers to search data bases and emails and video calls to talk between doctors at different inter-stellar locations. The doctors even had high tech gizmos to look inside and offer a 3-d look within. All medical records were online and available anywhere. New advances in medicine came from experience, science as well as other cultures and the experience of the treating physician. Patients and doctors could review information online and use that to improve their own care.
What wasn’t so out of reach was the portrayal of the practice of medicine and the limitations of what the human physician could achieve. The bedside manner was always first and foremost the key element to a patient’s survival. The physician treated all patients, regardless of species, and had tolerance for different cultural beliefs in treatment. And, not all patients made it through their ordeal. After all, the doctor was “just a man, not a miracle worker”.
So, Trek’s docs were all health 2.0 with a healthy dose of health 1.0 in that they had these important features:
1. high tech gizmos and computers to diagnose and treat
2. traditional docs to take a history and offer counsel but computerized medical records
3. limits on what could be done
4. online communication with “Googling” ability
5. New advances and lessons from other species to tackle new issues and problems
Sounds a great deal like our health system, minus the insurance headaches, huh?
The practice of medicine is begging to be more health 2.0 but with doctors who very much want and need to be involved and keep their health 1.0 skills. Today we have gizmos that keep becoming more high tech…think robotic surgeons. Today we have doctors still driving clinical care with bedside manner still crucial to the success of an outcome. Today we still have limits of what can and can not be done, with a limit of human life, regardless of our efforts to prolong it. Today we have very robust online communication between doctors, between patients, between doctors and patients, and between everyone and the computer, but with an importance still placed on the face-to-face visit.
There’s one big difference between the docs on Trek and us…insurance. Because of that, what we see on Trek is still just a dream. Those docs can do their jobs so admirably and with great patient satisfaction because they are not burdened with an insurance system gone awry and not forced into cycles of defensive medical practices.
Until health reform sorts out how to allow us to have a patient-focused, physician driven system again, what we see on Trek will remain a dream. What’s sad and discouraging is that is this is one sci fi dream that is actually within reach. Don’t you think it’s time we stopped the insurance companies from preventing us from grabbing on?
*This blog post was originally published at Dr. Gwenn Is In*
What is administration? It is the activities associated with coordinating human activity. It is real fantasy to think that physicians in the future, who will be even more dependent upon the activities of others, will be relieved of the responsibilities associated with coordinating these activities. When physicians controlled all the essential elements of the limited diagnostic and therapeutic repertoire, they could function relatively autonomously, albeit they had little to offer. Do we really want to roll the clock back to where we had control but control of very little?
Insurance is a flowed tool but what it primarily pays for functions as incentives to get people, including but not exclusively docs, to serve patients needs. As healthcare becomes increasing specialized, the coordination problem will become more and not less complex.
What is administration? It is the activities associated with coordinating human activity. It is real fantasy to think that physicians in the future, who will be even more dependent upon the activities of others, will be relieved of the responsibilities associated with coordinating these activities. When physicians controlled all the essential elements of the limited diagnostic and therapeutic repertoire, they could function relatively autonomously, albeit they had little to offer. Do we really want to roll the clock back to where we had control but control of very little?
Insurance is a flowed tool but what it primarily pays for functions as incentives to get people, including but not exclusively docs, to serve patients needs. As healthcare becomes increasing specialized, the coordination problem will become more and not less complex.