November 11, 2018

Everything that Atul Gawande writes is incisive and excellent, but this latest piece on why doctors hate their computers is among the best he’s written.

Medicine is a complex adaptive system: it is made up of many interconnected, multilayered parts, and it is meant to evolve with time and changing conditions. Software is not. It is complex, but it does not adapt. That is the heart of the problem for its users, us humans.”

I’ve been thinking a lot about digital health recently, and especially about how we design digital services for those whose job it is to serve others (this line of thought is, after all, a core part of my day job) and this piece encapsulates a lot of the issues that I’m exploring around the inherent Taylorism built into the design of our digital services.

Squeezing more patients into an hour is better than spending time entering data at a keyboard. More people are taken care of. But are they being taken care of well? As patients, we want the caring and the ingenuity of clinicians to be augmented by systems, not defeated by them. In an era of professional Taylorization—of the stay-in-your-lane ethos—that does not seem to be what we are getting.”

Why Doctors Hate Their Computers should be required reading for anyone in the world of digital health, digital government, and enterprise technology.

The volume of knowledge and capability increases faster than any individual can manage—and faster than our technologies can make manageable for us. We ultimately need systems that make the right care simpler for both patients and professionals, not more complicated. And they must do so in ways that strengthen our human connections, instead of weakening them.”

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