How to stop treating doctors like mushrooms

They seem to have collapsed in our time.

We've gone from Dr. Kildare to Scrubs, from M*A*S*H to House. Doctors feel like mushrooms, told nothing while manure is shoveled on them. Increasing numbers are mad as hell and aren't going to take it anymore.

This is especially true regarding technology:

• Doctors are expected to pay for EHRs, and learn to use EHRs, but the benefits go elsewhere.
• Trends like comparative effectiveness seem aimed at turning doctors into bus drivers.
• Patients are encouraged to use PHRs to second-guess everything the doctor says.
• Doctors are spending more time justifying themselves and trying to get paid than seeing patients.

Technology can turn these trends around as readily as it can make them worse.

In writing about the $20 billion in health IT contained in the President's stimulus bill, Technology Review writer Emily Singer makes a move toward a sale based on this key value -- prestige -- then goes right back to selling its value to patients.

And noting its cost, in training, to doctors. When was the last time you heard anyone squeal with delight knowing they were going to an IT training class?

What we need to do is emphasize how health IT can increase the value and prestige of line physicians:

• Having more data at the point of care.
• Simplifying paperwork.
• Eliminating the hassles of being paid.
• Spending more time on each patient.
• More assurance that the decisions they make are right.

But we need to do more than that. We also have to fulfill those promises once they are made.

Doctors, I have found, are a lot like journalists. They want to spend their time doing what they do. They want to work in their businesses, not on their businesses. They want respect. Most of all they want control, over what they do and how they do it.

Technology, in theory, can give doctors all these things. But over the last decade health IT has been sold based on benefits to everyone else -- vendors, insurers, hospitals, patients -- while the men and women at the center of it all have been largely ignored.

Moving IT spending from the private sector to the public sector may not change this. But if those working on the details of this spending did make doctors the center of what they were doing, it could.

And doctors might then stop fleeing the profession.