Docs seek balance between tech advances, patient empathy

I recently attended the annual Stanford Medicine X conference, a gathering of Silicon Valley start-ups, open-minded physicians, and outspoken patients (called ePatients) with chronic illnesses. This cornucopia of characters is the brainchild of Dr. Larry Chu, a professor of anesthesiology at Stanford with a penchant for social media and all things future-oriented.

MedX proved to be a dizzying mix of ideas. In a large conference hall mood-lit to look like the interior of a Virgin America airplane, a techno DJ played pulsing music between TED-like talks onstage. The ePatients talked about their financial hardships and not being listened to by doctors. Venture capitalists promised the advent of a new age in personal genomics. Never before have compassion and technological advances in medicine looked or sounded so cool.

Yes, we are in an era that demands most of a medical conference to talk about compassion. This year’s theme was center on the need for patients to be heard – to be considered a “person and not a chart.” The ePatients said, “Look at me, not at the computer.” They largely succeeded in opening our eyes to their plights, but they were, essentially, preaching to the choir. The doctors attending MedX were the type who blog and reach out to patients on social media and who advocate for better physician-patient relationships. Some of them even had titles like “Health Care Empathy Consultant” and “Engagement Behavior Designer.” Others, like Wendy Swanson, whose not-so-secret Twitter identity is @SeattleMamaDoc, received a breathless Beyoncé-level reception.

These physicians in the new field of empathy leadership, though, are taking their message to the hospital, with support from hospital administrations. Evidence presented at MedX clearly showed that when some doctors are coached to be nicer and more engaged, costs can go down and patient satisfaction can go up. That’s the kind of music hospital executives want to hear, since we have entered an era that increasingly stresses patient satisfaction, with likely consequences from Medicare and health insurers if a hospital or doctor falls short in this area. I heard someone joke that they were building an app that would give a doctor an electric shock for not being empathetic.

So what was happening in the tech talks? Were there tools being developed to increase patient satisfaction? Well, for some people – mainly healthy, well-off people who aren't even patients yet. Websites and apps that purport to track your FitBit steps, your MyFitnessPal daily food logins, your sleep monitors, all abounded. A few days later, Apple's HealthKit debuted, with the capability to sync with FitBits and food apps. 

Some of these apps monitor actual medical data, but most of those are limited to blood sugar and blood pressure. All this works well for a technology-savvy person with serious patience (logging daily meals is rather tedious) and disposable income to buy gadgets. But in many cases, the extra blood pressure or exercise data is overwhelming for the doctor and doesn’t necessarily change the treatment plan more than, say, a handwritten notebook would. How is “Don’t look at the computer” reconciled with, “Look at my FitBit data”? And what about people without smartphones? 

Overall, MedX highlighted a disconnect between patients’ desires for more attention and doctors’ decreasing attention spans. In an era when some doctors’ schedules allot 15 minutes to meet a new patient, get a complete history, execute a full physical, figure out the plan, fill out prescriptions, and document the entire thing, a pretty graph depicting steps walked over the past month doesn’t do much to add empathy to the visit.

But there were signs of hope. One project focused on turning complicated prescription drug instructions into fun, easy-to-read graphics. Another startup aims to create virtual post-operative visits between surgeons and patients. A smorgasbord of new businesses want to help patients access their own health data.

Medicine is going through growing and shrinking pains at the same time. Conferences like MedX illuminate where we are falling short with our patients and where opportunities for change exist.

Photo by Stanford Medicine X via Flickr.