Thursday, September 07, 2006

What Doctors Do

My wife and I just came back from visiting my brother- and sister-in-law (both physicians) and their children. It was time to leave, and we explained to their daughter (not yet four), that we had to go because we had to work tomorrow.

My sister-in-law asked her, "What do Kannan and Priscilla do? They do the same thing as Mommy and Daddy... remember we visited Daddy at work the other day? What does he do?" she prompted helpfully.

Without missing a beat, my niece said, "Sits on the computer!"

My three year-old niece already has a more realistic grasp of what a doctor's day is like then I had until my third year of medical school. Really. When I was a medical student, I was sure that most of the time doctors spent in hospitals was face-to-face with patients. I was very surprised to find this not to be true: most of the time a doctor spends in the hospital is spent with other doctors, nurses, charts, or indeed computers! In modern medicine, talk is literally cheap-- docs don't get paid much to do it. Rather docs get paid to do stuff to people. But wait, to get paid, you have to prove you did something. And to do that, you have to document. Documentation is also a good idea from a legal perspective. And it goes without saying that good documentation is good medicine -- patients benefit from having their story and their doctors ideas about their story clearly laid out in the record. But all of this means a lot of computer time.

I came across some interesting thoughts on the burden of documenting in a book entitled "The Young Doctor Thinks Out Loud." In it, the author Julian Price laments:
"...Right here we have one of the great nightmares of the intern's work--so-called 'paper-work.' I think that it is a conservative estimate to say that from ten to twenty-five per cent of the average inter's time on duty is spent in writing, depending upon the hospital and upon the conscientiousness of the young doctor. There is no more monotonous task that the writing of "histories and physicals." How often one feels that he is really not a physician, but just a stenographer..."
This was published in 1931. That's 75 years ago!

I guess things really haven't changed that much; we've just traded writer's cramp for carpal tunnel syndrome.


Anonymous cathy said...

Dr Kannan, You might want to move my link down to your "other" link list. I am not a medical professional. I have a brother who is a physician, but I am only a patient who loves reading the medical blogs. I also leave comments, but only from a patients perspective. I have a BS in chemistry from Ohio State, from about a zillion years ago. But that is as high as my education went.

Thank you for linking me!!

3:22 PM  
Anonymous H-Doc said...

My Waterman fountain pen is my best tool of the trade in the outpatient clinic - the stethoscope comes second

2:05 PM  
Blogger delobbo said...

Nice story, man. Kids seem to have a better sense of reality than adults do sometimes. Striking.

2:03 PM  

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