Through a Glass, Darkly by Pat Conrad MD

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To start, I wear glasses and have for years, so forget the vanity concerns. There is a lot of buzz lately on doctors starting to use Google Glass face-worn computers. Medical centers are starting to study their use in emergency rooms. Medical students are starting to be paired with them. Some surgeon’s are “glassing” as well.

As a gut level, initial reaction, my instinct says “&*$%#@.” Look at all the problems we already have created by accepting, and then forcing computers to be part of the patient encounter.

Several years ago in another state at an anonymous and for all you know fictitious hospital, I knew a colleague who was accused of using his cell phone to snap pics of a female patient au natural. That it was later shown conclusively that this old codger was too tech-tarded to even operate his phone reliably was beside the point, and the damage was done.

Google Glass (GG) allows not only perusing the web and hospital records via WiFi, but can also be used to shoot photographs or video.

We can expect to see:

  • GG records subpoenaed by the helpful malpractice attorney.
  • GG having to pass additional HIPAA certification.
  • Hospitals only allowing provided GG to access their networks; those same hospitals having uninterrupted, real-time access to the set for “quality control” or some other pretense, leaving doc’s to wonder whether the hospital is monitoring their encounters.
  • Docs checking emails from their accountant, attorney, or college roommate while staring directly at a patient.
  • Docs who wear GG being sued by a patient who claims the doctor was checking emails or web surfing while they were talking, missing the key detail that led to a bad outcome.
  • Docs who watch porn while a patient is talking.
  • Docs who read texts from their wives asking them to pick up milk and toilet paper on the way home, during the patient interview.
  • Docs who get so damn bored with the 10th visit that month from a chronic patient that they YouTube that funny video of the kid shooting the bottle rocket out of his butt (and if you never saw it, honestly, its my favorite clip . Turn up the volume!).
  • A patient complaining to her board of medicine because the doc was wearing GG while performing a pelvic.
  • New parents asking the OB for video of the c-section – and being pissed when they don’t get it (can you imagine walking out to talk to a grieving family after calling a code on their dead loved one, forgetting that the silly damn thing was still on your face?)
  • Vendors, quasi-government parties, and government agencies pushing for mandatory GG competence and use (however meaningful) as new quality indicators.
  • Idiot organizations like the AAFP evolving MOC “opportunities” to include recording encounters via GG to submit for review and critique.

I’m not anti-technology, and love being able to type this on my laptop and shoot it through my home network to all of you. And I can see how a wilderness area ER doc or surgeon would like to use this technology to confer real-time with a colleague or get guidance from a specialist. But the overall effects of this gadget will be to further depersonalize the patient-doctor interaction by inviting external, intrusive forces into the exam room.

Douglas Farrago MD

Douglas Farrago MD is a full-time practicing family doc in Forest, Va. He started Forest Direct Primary Care where he takes no insurance and bills patients a monthly fee. He is board certified in the specialty of Family Practice. He is the inventor of a product called the Knee Saver which is currently in the Baseball Hall of Fame. The Knee Saver and its knock-offs are worn by many major league baseball catchers. He is also the inventor of the CryoHelmet used by athletes for head injuries as well as migraine sufferers. Dr. Farrago is the author of four books, two of which are the top two most popular DPC books. From 2001 – 2011, Dr. Farrago was the editor and creator of the Placebo Journal which ran for 10 full years. Described as the Mad Magazine for doctors, he and the Placebo Journal were featured in the Washington Post, US News and World Report, the AP, and the NY Times. Dr. Farrago is also the editor of the blog Authentic Medicine which was born out of concern about where the direction of healthcare is heading and the belief that the wrong people are in charge. This blog has been going daily for more than 15 years Article about Dr. Farrago in Doximity Email Dr. Farrago – [email protected] 

  2 comments for “Through a Glass, Darkly by Pat Conrad MD

  1. May 22, 2014 at 10:40 am

    People don’t know that this development too closely approaches pornography. Visit Jacques Lacan and think about The Gaze that controls. He is a psychiatrist – an old-days, thinky-type psychiatrist. The power of the vision keeps the prisoners in line. Also look up feminist film critic Laura Mulvey in the UK – how the Gaze is used regarding women and controlling women.
    Are we to be medical lechers, then – getting people to show us their inner secrets for the camera, and then recording it onto the “confidential” medical record? Can we trust the decency of the unknown viewer? What is the history of the TSA in posting naked pictures of passengers, who were photographed “in the interest of security?”
    Isn’t this the summit of pathological Victorianism – everything about the care of the body is dirty, nasty, to be seen on YouTube? Privacy be damned – everyone look and laugh at Fatty Fatty Grandpa!
    Isn’t this what molesters do?

  2. Kurt
    May 21, 2014 at 12:24 pm

    Hmmmmm, I ve been hobbled for 6 days now that the EHR has died at both the hospital
    and clinic. So much for the fancy dancy electronification. Somebody didn’t plan ahead.
    Kurt

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