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Nothing we lose nothing. It's so frustrating...people LOVE to drum up fear about technology. But technology is an enhancer! It doesn't prevent anyone from doi

Nothing we lose nothing. It's so frustrating...people LOVE to drum up fear about technology. But technology is an enhancer! It doesn't prevent anyone from doing anything they did before. If you want to use a horse and cart go for it. If you want to use a old fashioned rolodex instead of Facebook go for it. Use the tech or don't. The problem is people resist change even if it's for the objective scientifically proven better.

cassowary37 8y ago
sorry, but this exhibits a complete disregard for (or lack of understanding of) the practice of medicine. Many of us love technology - some of us even read hn. But physicians have very little choice regarding use of this kind of technology, other than to leave medicine or go into private practice where we only take care of wealthy people. And re EHR in particular: is this technology an enhancer as you claim? Because it sure isn't reflected in any objective measures of clinical outcomes.
- epmaybe 8y ago
  I agree, but what if the ideal for EHR just hasn't been realized yet? Regulation or not, there must be ways to improve. We probably don't see those innovations because most hospitals stick to the juggernauts such as Epic for their software.
- nicodjimenez 8y ago
  You poor thing, it must be really hard having so much job security and such inflated salaries, due to artificial constraints on the supply of doctors by the medical mafia. You're not going to get a ton of sympathy here on HN, where your job or startup will get replaced in the bat of an eye whenever someone / something comes along that's better / cheaper.
  - econochoice 8y ago
    > your job or startup will get replaced in the bat of an eye whenever someone / something comes along that's better / cheaper. Anyone that works to eat is in the same boat.
    - nickthemagicman 8y ago
      Exactly and it will remove the artificial physician monopoly and put them in the same boat with the rest of the world
  - dang 8y ago
    It's not ok to attack a fellow user like this on HN, and we ban accounts that do it, so please read https://news.ycombinator.com/newsguidelines.html https://news.ycombinator.com/newsguidelines.html and follow the rules from now on. That means posting civilly and substantively, or not at all.
- nickthemagicman 8y ago
  I can't even fathom how EHR is not better for patients. Having a patients entire history at your fingertips collected through their lifetime. Being able to apply machine learning to their symptoms to find possible obscure issues Being able to combine data from populations to find new symptoms for illnesses Being able to identify outbreaks alot faster Better ability to analyize complex data to prevent drug interaction And so many more. No I think primary care and internal medicine physicians are threatened by technology and are resisting it, because 95% of what their job consists of is exactly what computers are really really good at, crunching data to find statistically likely outcomes. Tech is going to do to medicine what is already happening in Law. Put 90% of physicians out of business by making the few employed physicians infinitely more productive. In a 20 years we're going to view having a physician diagnose you as primitive as having a physician bleed you with leeches.
  - danielh96 8y ago
    Those things aren't being done with the EHR data, at least in the real world yet. Those benefits aren't being realised yet (which is far more likely due to regulation of the data rather than EHR uptake). To doctors, an EHR is just a replacement for paper with a clunky, hard to use interface. It's hard to beat the flexibility of paper. From what I've seen from EHRs and other related software, they're absolute garbage to use. I wouldn't want to use one either.
Para2016 8y ago
I'm curious, what examples did you see in the article that were indications we were "losing nothing"?
xapata 8y ago
Requiring technology means requiring capital investment, which means few solo practitioners (already happened) and practices controlled by massive bureaucracies. This has benefits and costs.
- nickthemagicman 8y ago
  I use the same technology for my personal projects (AWS, Rails, C#) that my company does for it's enterprise projects. My social worker friend already uses a SaaS for his billing and patient management. I think technology will massively enable solo practitioners.
  - xapata 8y ago
    Ask a medical doctor or dentist how much they pay for the various technology they use in their office. Even electronic medical records, as useful as they are, will have some negative effects for patients via the economics of medicine. EMRs are net positive, of course. Perhaps some day, the medical field will experience the same boom in open source and inexpensive services. That day ain't tomorrow.
    - nickthemagicman 8y ago
      I don't trust physicians or dentists opinions on this subject, because they have a vested interest in preventing technology from disrupting their field. Its better to be the oracle with the Tea Leaves garnering the accompanying salaries and status. >> Perhaps some day, the medical field will experience the same boom in open source and inexpensive services. That day ain't tomorrow. You're right it's today. There's a bunch of HIPPA compliant, reasonably priced SaaS's available to do just this. Google it. The obstacle lies in getting medical professionals to give their status, cush jobs, and money over to a machine for the betterment of patients and the field, which is going to be a hard won battle. I for one can't wait until a nurse with good beside manner takes my samples and symptoms, sends them to a lab/records them in an EHR, and a machine with zettabytes of data and years of machine learning diagnosis me with more accuracy than a human ever could imagine.
himom 8y ago
Yup. The article presents a luddite’s false dichotomy. Evidenced-based medicine and critical-thinking skills are complementary. Moreover, I’d prefer automation and optimization of as much of the repetitious work as possible... checking drug interactions, CADx comprehensive differential diagnonsis symptoms listing, CADe in radiology as a second-opinion and more. It is also annoying when professional “priests” commit what amounts to claiming only they have the mystical gifts to interpret what aren’t “tea leaves,” when it’s usually done out of fears of job security, special power and/or change of a legally-protected professional class.
- nickthemagicman 8y ago
  Exactly. Medicine is taking a set of data (symptoms) about an ill patient and determining the statistically likely problem. It's a basic data analysis which is exactly what computers are good at. No Tea Leaves involved. This whole pushback by physicians is about status, jobs, wealth, etc. In a 20 years we're going to view having a physician diagnose you as primitive as having a physician perform bloodletting or trepanation on you.

cassowary37 8y ago

sorry, but this exhibits a complete disregard for (or lack of understanding of) the practice of medicine. Many of us love technology - some of us even read hn. But physicians have very little choice regarding use of this kind of technology, other than to leave medicine or go into private practice where we only take care of wealthy people. And re EHR in particular: is this technology an enhancer as you claim? Because it sure isn't reflected in any objective measures of clinical outcomes.

epmaybe 8y ago
I agree, but what if the ideal for EHR just hasn't been realized yet? Regulation or not, there must be ways to improve. We probably don't see those innovations because most hospitals stick to the juggernauts such as Epic for their software.
nicodjimenez 8y ago
You poor thing, it must be really hard having so much job security and such inflated salaries, due to artificial constraints on the supply of doctors by the medical mafia. You're not going to get a ton of sympathy here on HN, where your job or startup will get replaced in the bat of an eye whenever someone / something comes along that's better / cheaper.
- econochoice 8y ago
  > your job or startup will get replaced in the bat of an eye whenever someone / something comes along that's better / cheaper. Anyone that works to eat is in the same boat.
  - nickthemagicman 8y ago
    Exactly and it will remove the artificial physician monopoly and put them in the same boat with the rest of the world
- dang 8y ago
  It's not ok to attack a fellow user like this on HN, and we ban accounts that do it, so please read https://news.ycombinator.com/newsguidelines.html https://news.ycombinator.com/newsguidelines.html and follow the rules from now on. That means posting civilly and substantively, or not at all.
nickthemagicman 8y ago
I can't even fathom how EHR is not better for patients. Having a patients entire history at your fingertips collected through their lifetime. Being able to apply machine learning to their symptoms to find possible obscure issues Being able to combine data from populations to find new symptoms for illnesses Being able to identify outbreaks alot faster Better ability to analyize complex data to prevent drug interaction And so many more. No I think primary care and internal medicine physicians are threatened by technology and are resisting it, because 95% of what their job consists of is exactly what computers are really really good at, crunching data to find statistically likely outcomes. Tech is going to do to medicine what is already happening in Law. Put 90% of physicians out of business by making the few employed physicians infinitely more productive. In a 20 years we're going to view having a physician diagnose you as primitive as having a physician bleed you with leeches.
- danielh96 8y ago
  Those things aren't being done with the EHR data, at least in the real world yet. Those benefits aren't being realised yet (which is far more likely due to regulation of the data rather than EHR uptake). To doctors, an EHR is just a replacement for paper with a clunky, hard to use interface. It's hard to beat the flexibility of paper. From what I've seen from EHRs and other related software, they're absolute garbage to use. I wouldn't want to use one either.

Para2016 8y ago

I'm curious, what examples did you see in the article that were indications we were "losing nothing"?

xapata 8y ago

Requiring technology means requiring capital investment, which means few solo practitioners (already happened) and practices controlled by massive bureaucracies. This has benefits and costs.

nickthemagicman 8y ago
I use the same technology for my personal projects (AWS, Rails, C#) that my company does for it's enterprise projects. My social worker friend already uses a SaaS for his billing and patient management. I think technology will massively enable solo practitioners.
- xapata 8y ago
  Ask a medical doctor or dentist how much they pay for the various technology they use in their office. Even electronic medical records, as useful as they are, will have some negative effects for patients via the economics of medicine. EMRs are net positive, of course. Perhaps some day, the medical field will experience the same boom in open source and inexpensive services. That day ain't tomorrow.
  - nickthemagicman 8y ago
    I don't trust physicians or dentists opinions on this subject, because they have a vested interest in preventing technology from disrupting their field. Its better to be the oracle with the Tea Leaves garnering the accompanying salaries and status. >> Perhaps some day, the medical field will experience the same boom in open source and inexpensive services. That day ain't tomorrow. You're right it's today. There's a bunch of HIPPA compliant, reasonably priced SaaS's available to do just this. Google it. The obstacle lies in getting medical professionals to give their status, cush jobs, and money over to a machine for the betterment of patients and the field, which is going to be a hard won battle. I for one can't wait until a nurse with good beside manner takes my samples and symptoms, sends them to a lab/records them in an EHR, and a machine with zettabytes of data and years of machine learning diagnosis me with more accuracy than a human ever could imagine.

himom 8y ago

Yup. The article presents a luddite’s false dichotomy. Evidenced-based medicine and critical-thinking skills are complementary. Moreover, I’d prefer automation and optimization of as much of the repetitious work as possible... checking drug interactions, CADx comprehensive differential diagnonsis symptoms listing, CADe in radiology as a second-opinion and more. It is also annoying when professional “priests” commit what amounts to claiming only they have the mystical gifts to interpret what aren’t “tea leaves,” when it’s usually done out of fears of job security, special power and/or change of a legally-protected professional class.

nickthemagicman 8y ago
Exactly. Medicine is taking a set of data (symptoms) about an ill patient and determining the statistically likely problem. It's a basic data analysis which is exactly what computers are good at. No Tea Leaves involved. This whole pushback by physicians is about status, jobs, wealth, etc. In a 20 years we're going to view having a physician diagnose you as primitive as having a physician perform bloodletting or trepanation on you.