Through a Glass, Darkly by Pat Conrad MD

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.