Doctor Robot for You, Real Doctor for Me

DMV type medicine should not be allowed to replace competent caring physicians writes Marilyn M. Singleton, MD, JD.

A couple of years ago, computer programs, algorithms, and glorified Google searches were touted as the replacements for a physician’s analysis of a patient’s medical condition. Compressed medical research is quite useful for clinicians who are presented with novel situations and have no readily available colleagues with whom to discuss the case. However, the purpose of flow charts should not be to replace the brains of busy clinicians or, worse yet, be a cookbook for the practitioners at drugstore clinics.

Marilyn M. Singleton, MD, JD. Image Credit: Author.

Medical technological aids have now jumpedthe shark. An unbelievable, but - thanks to cell phone video - verifiably truenews report detailed how a robot rolled into a patient’s Intensive Care Unitcubicle and a physician’s talking head appeared on the robot’s “face” and toldthe patient the sad news that he had a terminal illness. While remote medicineis reasonable in rural areas where access to medical care is limited, telling apatient he is going to die from a TV screen is a crime against all medical ethicalprinciples.

We can certainly expect more medicine byproxy as larger corporations and the government take more control of ourmedical care. The patient becomes secondary to the goal of “value-based care”or some other medically meaningless metric developed by government bureaucratsto give the appearance of managing costs.

It is highly unlikely that the ruling class(aka legislators) or elitist wannabes (aka limousine liberals) would tolerate arobot doctor. And neither should we.

Thankfully, people are waking up to theincremental erosion of their freedoms, and they are using the free market tofind ways around being treated like mindless cattle. In California, where thereis a 3-month wait for an appointment at the Department of Motor Vehicles (DMV),for a modest fee a private company will get you an appointment in two weeks.For a little more moola, they’ll have a surrogate stand in line in your stead.Almost on cue, our fearless leaders put forth a bill to outlaw the servicebecause it is “unfair.” What is unfair is a monopolistic government servicethat holds working people hostage to its incompetence.

DMV style medicine is gradually supplantingindividualized care. Clinicians are sharing reports of chronic pain patientsbeing harmed by government one-size-fits-all guidelines pulled together in aneffort to stem the tide of opioid abuse. Health Professionals for Patients inPain, a large group of prominent academic and private physicians, have urgedaction on this issue. In a letter to the Centers for Disease Control andPrevention (CDC) and relevant House and Senate Committees the group advisedthat “patients not only have endured unnecessary suffering, but some haveturned to suicide or illicit substance use” or had their conditions deteriorate.

It would be disastrous to even morepatients if this paint-by-the-numbers approach to our medical care wereexpanded. If - as the Medicare for All bills proposes - all private insuranceis outlawed and the government is the sole arbiter of our medical care, whatare average people to do? Stay behind the electrified fence and chew their cud?

At a time when depression and suicide areincreasing at an alarming rate, the personal touch is more crucial than ever.If you want to ensure that your doctor treats you like an individual, run –don’t walk to a direct-pay or a direct primary care (DPC) practice. For amonthly fee from $10 to $140 based on age, you can receive all basic medicalservices, lab tests and medications at amazingly low prices. Best of all, youwill have an empathetic and humane doctor who has the time to be thorough andwhose face is not buried in a computer screen full of metrics and centralizedstandards.

The patient-physician relationship is the most effective part of doctoring. National Doctors’ Day was held on March 30th. Let’s make it mean something: just say no to cattle prods and robots.

Aboutthe Author

Dr. Singleton is a board-certified anesthesiologist. She is President of the Association of American Physicians and Surgeons (AAPS). She graduated from Stanford and earned her MD at UCSF Medical School. Dr. Singleton completed two years of Surgery residency at UCSF, then her Anesthesia residency at Harvard’s Beth Israel Hospital. While still working in the operating room, she attended UC Berkeley Law School, focusing on constitutional law and administrative law. She interned at the National Health Law Project and practiced insurance and health law. She teaches classes in the recognition of elder abuse and constitutional law for non-lawyers.

Originally published in  Issue 2, 2019 of MT Magazine.