Karen Garloch

Doctor: Look at patient, not the computer

Dr. Simon Ward III owns the latest iPhone 6 and regularly uses electronic medical records.

But as a Charlotte obstetrician-gynecologist for 28 years and the new president of the Mecklenburg County Medical Society, he warns doctors to be wary of letting technology detract from the practice of medicine.

“Even with a gazillion gigabytes at our fingertips, everything we need to know about our patients is in their face, in their voice and in their eyes,” Ward wrote in his first column for the society’s magazine this month.

With the rise of electronic medical records (EMR) and the constant use of computers in health care settings, Ward acknowledges that many doctors spend too much time looking at screens instead of at their patients.

“The folks who sold us these systems talked about all the wonderful things EMR can do,” Ward wrote. “… One might assume the EMR would excise the tumor, lower the blood glucose and stop the hallucinations. The problem is that the EMR really should not ‘do’ anything. Patients tell us their concerns. Practitioners do their best to listen and perform the appropriate evaluation, with or without technology.”

Ward told about his residency at the now-closed Charity Hospital in New Orleans. On busy nights, all the residents would be “in the back” delivering babies while new patients, pregnant women in labor, arrived for evaluation. By the time a resident got free, nurse aides had triaged the new patients and knew which ones were ready to deliver, which ones could go home and which ones should be watched.

“We always checked the patients because our professors expected it,” Ward wrote. “… (But) it was totally unnecessary; we did exactly what the aides had described. There were no fetal monitors in triage. The ultrasound machine was locked up for the night. The aides had not examined the patient because they were not allowed to. They just looked in the patients’ eyes and listened to them speak.… and they were NEVER wrong.”

That was in the 1980s, but Ward says the lesson is valid today. There’s a computer in his exam room, but he never turns it on, so he’s not distracted when he’s seeing the patient. Instead, he goes to a nearby room where he types notes on another computer.

“I just want to make sure that we use these things in their proper place and for good reasons,” he told me, “and not let them use us.”