Technology in Medicine: Disenchanting or Re-enchanting?
Moderator-
Emily Trancik, PhD., Saint Louis University
Panelists-
Michael Redinger, M.D., Western Michigan University
Steven Roskos, M.D., Michigan State University
Devan Stahl, PhD., MDiv., Assistant Professor of Clinical Ethics, Michigan State University
For the past decade, technology experts have predicted that robots are the future of medicine. Physicians rely so much on technology that one-day technology will replace them. When seen as the mere deployment of a science, it is logical that computers could practice medicine as well as or better than human physicians. For those who believe medicine is an art and a calling; however, robot physicians could never practice medicine. Few people would like to return to a time before MRI machines or robotic surgeries, but these technologies can create barriers between health care providers and patients when they are not mediated properly. Technology, in other words, can disenchant the doctor-patient relationship when physicians rely on it over and against their human to human interactions. At the same time, technology might have the capacity to re-enchant the doctor-patient relationship when properly deployed. The three speakers in this panel will explore how technology can both disenchant and re-enchant the doctor patient relationship and why this matters for our understanding of God, nature, and the purposefulness of the human body.
The first presenter will discuss the disenchanting effects of technology, primarily electronic health records (EHRs) and smart phones, on the doctor patient relationship in primary care. It is established that the EHR has had primarily adverse effects on patient-centered communication in the primary care office, reducing eye contact, rapport and provision of emotional support. For many of us in primary care it was these relational, even spiritual, aspects of practice that drew us to this specialty. Using Martin Buber’s taxonomy, patient “encounters” characterized by relationship are being replaced by patient “experiences” characterized by data collection and analysis. We will first discuss information from the literature and this presenter’s experience regarding EHR and Smart Phone disenchanting of medical practice, then discuss ways in which medical practice can be re-enchanted despite technology’s influence, and how technology can even be employed toward this end.
The second presenter will discuss the ambivalent relationship his medical specialty of psychiatry has with technology. Psychiatrists believe themselves to be masters of the invisible space between physicians and their patients, claiming to have the skills and insight which enable them to establish a unique kind of relationship in which communication not only allows them to diagnose, but also to heal through a variety of psychotherapeutic techniques. As a result, many psychiatrists are wary of the introduction of technology into therapeutic setting, often basing their concern on the ways in which technology has been witnessed to be “disenchanting” in other medical specialties. On the other hand, others, such as Henry Nasrallah, see the future practice of psychiatry best guided through whole-hearted embrace of brain-based medical technology, which has been stunted by the complexity of the brain and relative lack of research funding compared to other medical specialties. This debate is timely, as on the horizon lies the holy grail of technological advancement for psychiatric practice: definitive biomarkers to diagnose mental illness and provide individualized treatments. The presenter will discuss if it is possible for psychiatry to integrate this potentially paradigm-shattering development in medical technology into mainstream practice in a way that are more likely to enchant than disenchant and what lessons may be learned from other medical specialties who have encountered similar periods of change.
The third presenter will represent the patient perspective by discussing her personal experience being diagnosed with a chronic illness through a medical image. Medical images can easily disenchant the doctor-patient relationship by putting up a technologically-mediated object that only the physician can interpret. Such objects create barriers between the physician and patient, particularly when they are valued over and above the patient’s embodied experiences. Contemporary medical imaging techniques participate in a kind of knowledge production that cannot help but objectify the human body. “Looking in order to know” and “showing in order to teach” as Michel Foucault states, creates a tacit form of violence upon the sick body that demands to be comforted and not displayed. Patients seek medical care in order to be made whole, only to have themselves fragmented and objectified by the physician, often for the sake of teaching younger physicians, or for communicating with other doctors involved in the patient’s care. The presenter will offer tips for how physicians can use medical images in ways that do not abstract and objectify the patient, but instead help the patient to see herself anew and incorporate a new image of herself into how she understands the teleological purposefulness of the body. Finally, the presenter will offer suggestions for how patients can transform their medical images into useful and constructive depictions of their own body through the act of art-creation.
Emily Trancik, PhD., Saint Louis University
Panelists-
Michael Redinger, M.D., Western Michigan University
Steven Roskos, M.D., Michigan State University
Devan Stahl, PhD., MDiv., Assistant Professor of Clinical Ethics, Michigan State University
For the past decade, technology experts have predicted that robots are the future of medicine. Physicians rely so much on technology that one-day technology will replace them. When seen as the mere deployment of a science, it is logical that computers could practice medicine as well as or better than human physicians. For those who believe medicine is an art and a calling; however, robot physicians could never practice medicine. Few people would like to return to a time before MRI machines or robotic surgeries, but these technologies can create barriers between health care providers and patients when they are not mediated properly. Technology, in other words, can disenchant the doctor-patient relationship when physicians rely on it over and against their human to human interactions. At the same time, technology might have the capacity to re-enchant the doctor-patient relationship when properly deployed. The three speakers in this panel will explore how technology can both disenchant and re-enchant the doctor patient relationship and why this matters for our understanding of God, nature, and the purposefulness of the human body.
The first presenter will discuss the disenchanting effects of technology, primarily electronic health records (EHRs) and smart phones, on the doctor patient relationship in primary care. It is established that the EHR has had primarily adverse effects on patient-centered communication in the primary care office, reducing eye contact, rapport and provision of emotional support. For many of us in primary care it was these relational, even spiritual, aspects of practice that drew us to this specialty. Using Martin Buber’s taxonomy, patient “encounters” characterized by relationship are being replaced by patient “experiences” characterized by data collection and analysis. We will first discuss information from the literature and this presenter’s experience regarding EHR and Smart Phone disenchanting of medical practice, then discuss ways in which medical practice can be re-enchanted despite technology’s influence, and how technology can even be employed toward this end.
The second presenter will discuss the ambivalent relationship his medical specialty of psychiatry has with technology. Psychiatrists believe themselves to be masters of the invisible space between physicians and their patients, claiming to have the skills and insight which enable them to establish a unique kind of relationship in which communication not only allows them to diagnose, but also to heal through a variety of psychotherapeutic techniques. As a result, many psychiatrists are wary of the introduction of technology into therapeutic setting, often basing their concern on the ways in which technology has been witnessed to be “disenchanting” in other medical specialties. On the other hand, others, such as Henry Nasrallah, see the future practice of psychiatry best guided through whole-hearted embrace of brain-based medical technology, which has been stunted by the complexity of the brain and relative lack of research funding compared to other medical specialties. This debate is timely, as on the horizon lies the holy grail of technological advancement for psychiatric practice: definitive biomarkers to diagnose mental illness and provide individualized treatments. The presenter will discuss if it is possible for psychiatry to integrate this potentially paradigm-shattering development in medical technology into mainstream practice in a way that are more likely to enchant than disenchant and what lessons may be learned from other medical specialties who have encountered similar periods of change.
The third presenter will represent the patient perspective by discussing her personal experience being diagnosed with a chronic illness through a medical image. Medical images can easily disenchant the doctor-patient relationship by putting up a technologically-mediated object that only the physician can interpret. Such objects create barriers between the physician and patient, particularly when they are valued over and above the patient’s embodied experiences. Contemporary medical imaging techniques participate in a kind of knowledge production that cannot help but objectify the human body. “Looking in order to know” and “showing in order to teach” as Michel Foucault states, creates a tacit form of violence upon the sick body that demands to be comforted and not displayed. Patients seek medical care in order to be made whole, only to have themselves fragmented and objectified by the physician, often for the sake of teaching younger physicians, or for communicating with other doctors involved in the patient’s care. The presenter will offer tips for how physicians can use medical images in ways that do not abstract and objectify the patient, but instead help the patient to see herself anew and incorporate a new image of herself into how she understands the teleological purposefulness of the body. Finally, the presenter will offer suggestions for how patients can transform their medical images into useful and constructive depictions of their own body through the act of art-creation.