“I tell them that their first reflex should be to look at the patient, not the computer,” says Dr. Paul A. Heineken, 66, a primary care physician and teacher of medical school students at the San Francisco V.A. Medical Center. Through his career, Dr. Heineken has seen the of emergence CT scans, ultrasounds, M.R.I.’s and numerous new lab tests. As technology has progressed, Dr. Heineken has also witnessed peers turn their backs on patients while grappling with a new computer system, or rushing patients so quickly through their appointments that they forget the most essential tools – their eyes and ears. And maybe because of changes he has seen in the medical profession over the years he makes it a point of stressing some “old-fashioned” principles to his students. “I say, ‘Don’t go to a computer; go back to the room, sit down and listen to them. And don’t look like you’re in a hurry. Any difficult clinical decision is made easier after discussing it with the patient.’ ”

Dr. Alvin Rajkomar, 28, a third-year resident in internal medicine at the University of California, San Francisco knows what it’s like to be on call for 24 hours, exhausted, yet relied upon to make crucial medical decisions quickly. Recently during his rounds he had to make a quick decision regarding a frail, elderly patient with a dangerously low sodium level. Dr. Rajkomar pulled out his iphone, tapped on an app called MedCalc and quickly got the answers he needed to start the saline at just the right rate.

The soaring increase of Web-based information, apps and gadgets have given doctors – particularly young ones, a new set of tools to work with. This has caused some older doctors to not only admire their younger conterparts’ ability to use the new technology, but also worry that the human bond between doctor and patient may be compromised. Is it possible for doctors to use  21st century technology effectively, while still maintaining the crucial human connections that are a foundation of medical practice? Dr. Paul C. Tang, chief innovation and technology officer at Palo Alto Medical Foundation in Palo Alto, California believes it’s achievable. “Just adding an app won’t necessarily make people better doctors or more caring clinicians. What we need to learn is how to use technology to be better, more humane professionals.”   nytimes.com   2/12/13







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