Talk to the Radiologist: Dr. Robert Wachter, University of Pennsylvania School of Medicine Commencement

Abstract

This week we have the pleasure of hearing Dr. Robert Wachter’s speech at the 2017 University of Pennsylvania School of Medicine Commencement, titled “Talk to the Radiologist.â€

 

Robert M. Wachter, M.D. is Professor and current Chair of the Department of Medicine at the University of California, San Francisco. He is also former President of the Society of Hospital Medicine and former Chair of the American Board of Internal Medicine. Having coined the term “hospitalist†in 1996, he is often considered the “father†of the hospitalist field, the fastest growing specialty in the history of modern medicine. Dr. Wachter is the author of 250 articles and 6 books.

In the safety and quality arenas, he edits the U.S. government’s leading website on patient safety and has written two books on the subject, including Internal Bleeding and Understanding Patient Safety, the world’s best selling safety primer. In 2004, he received the nation’s top honor in patient safety the John M. Eisenberg Award. In 2016, Modern Healthcare magazine ranked him as the fourth most influential physician-executive in the U.S., his ninth consecutive year in the top 50 (he was #1 on the list in 2015). He has additionally served on the healthcare advisory boards of several companies, including Google. His 2015 book, The Digital Doctor: Hope, Hype and Harm at the Dawn of Medicine’s Computer Age, is a New York Times science bestseller. He recently chaired a blue ribbon commission advising England’s National Health Service on its digital strategy.

 

We all have people in our lives that we credit with influencing our decision to become physicians. For Dr. Wachter, it was his father who played a significant role in this decision-making.  His father held a fascination with the medical profession. He went so far as to wear a garage door opener on his belt in imitation of a physician’s pager. Altogether, his father’s intrigue with medicine, as well as his unexpected and emergent cancer diagnosis, guided Dr. Wachter toward a career in medicine. He states:

 

            “The experience taught me many things. How terrifying illness is for patients and family members. How doctors aren’t necessarily too great at    prognosticating. And how important human-to-human contact is in medicine – not just between doctors and patients, but also among members of the care team.â€

 

“Medicine is changing.† Dr. Wachter conveys this message throughout the speech.  In particular, he focuses on the technological surge that is making its way through medicine.  He calls it “widespread digitization.â€Â 

 

Is this change for better or for worse?  He does not explicitly answer this question.  Instead, he encourages us to take these technologies and apply them creatively, namely in a manner that will improve our ability to care for patients.  He implores caution, however, as he reminds us that we signed up for this career to treat patients, not diseases.

 

            “As the work becomes digitized and the software gets better, we will spend   more of our time interacting with our digital tools, and less interacting with  each other, and with our patients. This is natural, and –assuming the tools are any good – it might even be OK. After all, computers will hold much of the information, and they will be where we develop and implement many of our diagnostic and treatment plans.

            But, there is a huge danger from hunkering down in our digital caves. You can never fully understand a consultant’s thinking by reading her note. You can  never place a complex radiology finding in context without speaking to the radiologist. You can never allay the anxiety of a sick patient’s spouse by sending a text message. And you can never comfort a dying patient without sitting at the bedside and holding his hand.â€

 

Indeed, technology will allow us to push the bounds of diagnostic and treatment capabilities.  In this regard I remain optimistic, though Dr. Wachter’s words have reminded me that at the end of the day, technology is a tool.  Tools supplement –not replace— our creativity, compassion, and ability to connect with others.

 

Dr Wachter concludes with a call to action:

             “We have the opportunity today to do more for our patients than ever before. And you have the knowledge, skills, values, and habits of mind to thrive in   this changing world. You are the ones who will reinvent the work to deliver   for our patients. And you will figure out how to balance our new digital capabilities with the enduring truth that medicine is, and must remain, the   most human of professions.

           

            Thank you for the honor of speaking to you today.   Congratulations to each and every one of you. “