High tech…High touch

Friday, August 31, 2007

High tech has come to football over the past many years with better equipment, coaching methods and communications, but game changing decisions remain mired in the very low-tech era. While television can put computer generated first down lines on the field, moving the chains involves really moving the chains. A referee puts the ball down with finality and two guys with poles connected by a chain run 40 yards across the field, stretch out the chain and declare a first down…or not. What happened to handheld range finders or GPS solutions? Regardless, fans are pretty happy with the status quo.

Patients aren’t quite as forgiving in medicine. Physicians and nurses spend years in training to gather experience to decide when to bring in the high tech science fiction that exists in medicine. Patients have become accustomed machines to “make” diagnosis and tell them what’s wrong. But there is skill to decide when a test will make a difference and how to interpret a result. The key to diagnosis remains low tech: talking with the patient and examining them.

Doctors need to be patient advocates and sometimes that means practicing tough love and saying no to the latest and greatest tests available. As a patient, wanting confirmation by a tangible test, a number, an x-ray or scan, validates what the doctor is saying. Yet ordering a shotgun full of tests isn’t always in the patient’s best interest. Tests that find mild abnormalities that can be variations of normal, may send the doc and patient off on wild goose chases for a diagnosis isn’t there. Sometimes, simple is better. Using time as an ally allows diseases or recovery to evolve.

Care providers who spend the time and effort to talk with their patients and educate them, may be low tech, but they yield high results with less risk. Recent research studies are finding that by relying on x-rays and CT scans, doctors are exposing their patients to too much radiation. Guidelines have been developed for ankle, knee and head injuries to decide whether an x-ray will make a difference. New guidelines are being studies for a variety of other injuries and illnesses.

It may be that the future may hold high tech in high esteem but for most people and most problems low tech is the way to a first down.

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