[in_cahoots]

I think the real implications are much more chilling. As much as we like to believe otherwise, there is always a chance that a seemingly-healthy college kid will drop dead of something that even the best doctor wouldn't have anticipated.

And as much as we would like to believe otherwise, the modern healthcare system is riddled with problems that no technology or checklists will fix. It doesn't take someone's death to verify this- just go read your own charts and discharge papers. Even for something relatively routine there are bound to be inaccuracies. Doctors know this, which is why they spend so much time doing handoffs and interviewing patients.

We pretend that the medical 'record' is infallible, helping to reduce the mental load on doctors while protecting them from liability. But as this case shows, the 'record' is both inaccurate and not useful in showing fault. It's a paper tiger. I'm not saying we should scrap the whole system, but I do think it needs to be examined in a data-driven manner.

[naijaboiler]

As a surgeon, one truly humbling fact about humans is we are simultaneously incredibly fragile and impossibly resilient. You will be shocked at what people can survive and what flimsy things kill people

[mandevil]

Almost 30 years ago I went to a Penn and Teller magic show. They did their bullet catch (classed up but basically the same trick people have been doing for a century) and other stuff I don't really remember.

The trick I vividly remember was just Penn standing behind a table, putting a piece of green cloth (like a surgical thing) over a water balloon, and then giving a long speech of all the damage that friends of his had survived, as he stabbed the balloon (under the cloth) repeatedly in time with his speech, and talked about the wonder of medical science, and how doctors he knew had saved people from all these horrendous accidents and damaging the balloon in sync with every example.

And then he removed his hands from the table, holding them up to the audience, leaving the balloon still under the surgical barrier, and said "And the other thing that doctors will tell you, if get a couple of beers into them, is that sometimes people just die for no reason at all." And the balloon collapsed right on cue.

I can't seem to find a video of it but I remember it clearly.

[terminalshort]

Technology can fix plenty. I have narcolepsy and was able to diagnose myself after multiple doctors had failed, and luckily I finally found a specialist in narcolepsy who could actually confirm it. Wouldn't be possible without Google (which any of those docotors could have used but didn't). I would probably still be searching for a doctor to actually do his job. Technology can solve plenty of problems. What we need to do is get the doctors out of the loop.

[sarchertech]

And for every person who correctly diagnoses themselves despite at odds with what a doctor is telling them, you have 10 people undergoing unnecessary, dangerous treatments because the misdiagnosed themselves.

[kelvinjps10]

So you think with just technology, using something like Google or AI, you would be able to correctly self-diagnose with the "doctors out of the loop"?

[terminalshort]

I was in my case (and I didn't even have AI back then) after multiple doctors failed miserably. Of course I needed to get the actual doctor diagnosis to get insurance to pay for my treatment, but that's bureaucracy, not medical science.

[in_cahoots]

I didn't say that technology won't fix anything, merely that it won't fix everything.

[fluoridation]

What do you mean? Isn't record-keeping a data-driven practice?

[in_cahoots]

No. I can transcribe every interaction with 100% accuracy, but if those notes aren't used in any way it's not data-driven. This article shows that the notes are inaccurate, suggestions using the notes are routinely ignored, and that doctors and legal review think this process is acceptable. There is no professional or legal liability if the records are wrong. And yet if you talk to a medical professional they'll explain that the records are to establish a legal paper trail if anything goes wrong.

Some executive(s) have been told that detailed medical records are the solution to so many problems in modern medicine. But they lack either the guts or the expertise to make sure that these systems are actually accomplishing what they set out to do.

[fluoridation]

>suggestions using the notes are routinely ignored

Of course. The records are known to not be 100% accurate. Any conclusion you derive from them will be faulty.

>There is no professional or legal liability if the records are wrong.

Again, of course. In many cases it may not even be possible to show a record is incorrect. For example, if the record doesn't say a test was performed, but the patient insists that it was, is the record wrong, or is the patient mistaken? Or a doctor could incorrectly write down something that only he saw, such as a blood pressure value on a gauge.

I would guess a key obstacle to eliminating all these inaccuracies is that doctors don't see strict record-keeping as actually useful in helping patients. Every minute that they're taking notes of dubious future utility is a minute they could spend seeing a patient.

[riknos314]

The real issue is the administration of the hospital sees every minute the doctors spend taking better records instead of seeing another patient as a loss of ability to bill someone's insurance for that time.

I'm sure there's many doctors who would like to take better notes if they were allowed the time to do so.

Maybe the case for better records reducing costs to insurance by assisting in prevention / early intervention is a path forward?