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On the Modernisation of Healthcare

 Written below is an essay I submitted for a contest, so I figured this would be a great way to revive my blog. Enjoy!


In the brightly lit hospital waiting room, only two figures could be seen, a father and his child - holding hands and huddled in a corner. The only sounds that could be heard were the frantic tapping of the father’s feet, his mutters of prayer, and the soulless drone of the air conditioner attempting to drown them out. The harsh lights bear down on the two of them, made almost blinding by its reflection off the pristine white tiled floor, causing beads of sweat to trickle down his forehead, giving a sheen to his gaunt expression. His phone buzzes. He takes a deep breath, lets go of the child, and with hands shaking, checks his phone. A few seconds elapse. A soft sob can now be heard, and the man has his head in his hands. His wife’s condition has taken a turn for the worse. She might not survive the night. The text message was the harbinger of the dreadful news he had feared. Yes, a text message. The child squirms uncomfortably in the cold steel chair, looking wide-eyed at her father with eyes full of innocence, aware that something is not right, but blissfully unaware of how egregious the situation was.


With, hopefully, the worst of the Covid-19 pandemic over, the world has begun to move in the direction of a dystopian future described above. Efforts are made to eliminate human contact, wherever possible, in an attempt to limit the spread of the disease. In manifold scenarios and different walks of life, this is genuinely desirable. One would be a glutton for punishment if less family time, commuting to work at the crack of dawn, and crowded lines in public spaces were preferred over ‘working from home.’ Healthcare is sue generis. It could ill afford this luxury. Human touch is quintessential for healthcare, and life, in this blue planet. We could admittedly do better than a text message.


The online era is a boon, but not in all healthcare domains. Virtual consultations, rapid access to information, public health surveillance and ordering medications online, to name a few, were unthinkable a decade ago. Multiple studies, however, have shown that patient satisfaction during this period reduced noticeably. A quest for what begets it would show reduced human contact as the offender. Patients entrust their body and mind with us. That trust is cast-iron. As professionals, we endeavour to improve and save their lives. A virtual meeting does not inevitably exude compassion and innately precludes a humane touch. It would, distinctly, be a poor substitute for face-to-face meetings.

 

In-person contact make patients feel safer, share their darkest fears with confidence, and more willing to implement our advice. Communication is more than just the words we speak. Albert Mehrabian, eminent psychologist and an expert in body language, had demonstrated that words account for only 7% of effective communication. The rest? 55% was body language and 38% was tone of the voice. When human interaction was removed, the effectiveness of patient-doctor communication was more than halved. How then, will we be able to empathise and ‘be there’ for them? 


Breaking bad news is a case in point. Often patients die under our care and it is our responsibility to inform, guide and counsel their families. In this process, a substitute for a human being does not exist. It is an emotional roller-coaster for the family, and every spoken word has to be chosen with care and precision. Dynamism of the human mind is paramount. The words we speak, our facial expressions, a genteel touch, or a hug even, demonstrates that we understand their grief; that we care. For many, that is the first step in the road to recovery.


The human influence on our surroundings matters immensely, too. It could be the architecture, the decor or personal memorabilia. Office workers display pictures of their family in the cubicle. It provides a sense of warmth and comfort in what would otherwise be an oppressive environment. Hospitals are no exception. The environment should be conducive to healing. Architects stress the significance of natural light, access to greenery, and pleasing aesthetics in hospital design. A building could just not be a square slab of concrete with windows interspersed. The decor and design, thought and executed by a human, for a human, could have nothing but a distinctly human feel. Assuredly, a stronger foundation for further healing.


Humans are not infallible. The perfect homo sapiens does not exist. Therein lies the argument for artificial intelligence. Utilising flowcharts and database approach, it could mitigate the mistakes of a tired doctor, do one better with pattern recognition, augment precision medicine, and prove to be cost-effective in the longer-term. IBM’s Watson Health, Fitbit, and The Da Vinci robotic surgical system, au contraire, could enable more face time with patients and less with paperwork. The notion, however, that doctors could be replaced downright with machines in the future is a fallacy. And a misguided one at that. Technology could supplement our creativity, compassion and critical thinking, not replace it.


If social media was to be believed, the intricate dance to find a balance has already begun. A doctor in California sparked outrage when he informed a patient that he was dying using a rolling video technology robot. Clearly an outside turn that went awry. All the same, we risk being archaic with our refusal to apply advanced technology in our practice. Only suboptimal healthcare accrues with such a disposition. Working with advanced machines is inevitable, and it is fine to be worried about the uncharted waters. What should worry us more, however, is how we tie it in with human touch.


As with all things in life, balance is the essence. Awaiting us at the gates, when we finish college, would be pressing questions. Questions that should be considered carefully, and at every step. Our answers would change the world.

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