An interesting article that expresses some of the nagging thoughts that "de-skilling" is becoming more obvious. I've tried to tell myself that I've become cyni

An interesting article that expresses some of the nagging thoughts that "de-skilling" is becoming more obvious. I've tried to tell myself that I've become cynical and biased with age, but the author's commentary about medical practitioners cuts too close to the bone, coinciding with my own observations. There's a great range of skill among doctors (any specialty), though a hard thing to quantify. I'd agree reliance on devices may not always be an asset or promote greater skill. Perhaps it's a bigger issue for the less experienced, but not really just a matter of years on the job. Of course using computers to find information (and for so many other purposes) can be extremely useful. However there's a trend to let the machine determine the scope of info one looks for, and when that happens, it's likely to lead to missing important clues in clinical practice. The key to expertise isn't knowledge, it's knowing the limits of knowledge. Knowing that one doesn't know is crucial and only learned by experience. Computers can't provide info not programmed in, and even worse, most of the time won't acknowledge lack of knowledge, that the humans have to rely on themselves. I often think about the benefit of experience I've accumulated. I put it this way, it took thirty years of practice to fully realize what I didn't know and that's what enables me to be so much better at it now. When used as a tool, an instrument to extend or refine, not replace, our powers of observation and problem-solving computers can be useful, our skills enhanced. But we have to exercise our own unaided senses to optimally develop our abilities and talents. The problem that's developing is misconstruing tools to be oracles and disregarding the power of our built-in computational facilities.