Medical technology - is society doomed?

[vreihen]

Background - Homey hasn't been feeling great for a few weeks, so I went to see my doctor yesterday morning. Homey's chosen primary care doctor is about as far off the grid as possible, using tools like blood pressure cuffs with stethoscopes and actual glass thermometers. Homey likes being off the grid with his medical records. Anyway, my doctor didn't like something found during the exam, and sent me off to the local hospital's ER with a "stat" test order and having called ahead to reserve a table for one and brief the ER doctor.

Before they take you to the ER, they have a screening room where they pull incoming vitals...probably for legal documentation for than diagnosis. The tech put the electronic blood pressure cuff on my arm, and I told her that she was wasting her time because the machine would not be able to read my pressure due to known conditions. After 5 minutes of inflate/deflate with no readings, she changed cuffs...then changed arms...then changed machines. Last time that I went through this, I was hospitalized for 11 days because the number it finally got a lock on was high enough to only give me 10 minutes to live. This time, I laughed it off, and even mentioned to the tech at one point that all of her technology was useless on me since I am from another planet. (I have a *very* weak heart function and low blood pressure/circulation, and the machines can't lock onto my pulse.) OK, so she charted that the patient has no measurable blood pressure, and moves onto the next test. Out comes the digital thermometer. I told her that she was again wasting her time, since my oral temperature is lower than the minimum range threshold for those machines. Two different cart machines and a portable electronic thermometer later, she charted that the patient had no measurable temperature and finally led me into the ER.

TL;DR - The ER staff repeated this same fiasco for the next 20 minutes using the same brand/model machines. If I wasn't conscious and talking to them, I probably would have wound up in the morgue based on their lack of readings!

When I finally got to see the ER doctor and (male) nurse, I asked if they had an old-school blood pressure cuff and liquid thermometer available. Believe it or not, there isn't one of either in the entire ER department!

Long story short, the people providing health care in our hospitals are mindless sponge-minions, enslaved by electronics and incapable of performing even the simplest medical tasks without technology. If something like a solar flare were to wipe out all electronics, our neighborhood hospital would not even be capable of diagnosing a fever because they wouldn't even have a working thermometer. Just something to keep in mind when stockpiling your bunker with survival essentials, because society is doomed from what I saw yesterday.

Oh, and to add insult to injury - I was asked by *four* different medical records people to confirm my pharmacy as part of the check-in process. The ER doctor sent an e-prescription to my pharmacy...but they never received it! So, I have to go to my regular doctor today to find out what the prescription was for and re-send it. New Yorkistan has decided that paper prescription pads are no longer permitted for most medications, so you also can't get medicines without filing electronically!!!!!

 

[Jack@European_Parts]

DONT LIKE BUTTON! /\

Art I agree............ mechanical old school devices have a place for sure........

GFF for hospital's...........just look how well it works in dealerships.

 

[Andy]

Did the people use a keyboard like this to check you in?

 

[Jack@European_Parts]

Hey that's from our favorite movie Art Idiocracy.........

 

[vreihen]

Did the people use a keyboard like this to check you in?

Hey that's from our favorite movie Art Idiocracy.........

Believe me Jack, I recognized that keyboard right away.....

 

[Uwe]

 

[vreihen]

GFF for hospital's...........just look how well it works in dealerships.

THIS sums it up the best.....

 

[NZDubNurd]

As someone who fixes and verifies these devices, I can tell you now - it's a lot like VCDS... (Jack will like this!)

...the devices are a TOOL, and you STILL need a user who knows what they are doing! It's not going to fix the problem FOR you!

For convenience, the electronic BP units (of reputable, repeatable quality and brands) are faster and take out some human error factor. However, concerns should be verified using old school methods, if the user isn't happy. Our ED mostly uses electronic units, but there are manual sphygmomanometers available.

It also worth noting, that the small BP devices available at pharmacies, are usually wildly inaccurate, and shouldn't be used for diagnostic purposes!

These things have their place, but clearly on YOUR arm isn't one of them :-)

It DOES scare me that medical professionals may come to rely so heavily on technology, that they don't really keep their skills honed!

I wonder if you situation is related to legal issues and patient record storage etc?

 

[Uwe]

It also worth noting, that the small BP devices available at pharmacies, are usually wildly inaccurate, and shouldn't be used for diagnostic purposes!

Hmm... My wife has a small electronic one. She has mildly high BP, easily brought down to 'normal' levels with a light dose of meds. She uses it fairly regularly to monitor the effectiveness of the meds. When she visits the doctor's office, the same one for 30+ years now, where they still use a manual sphygmomanometer, the numbers they record on her chart are very much in line with the ones she gets from the electronic gizmo.

I bet the ER Art went to has manual backup instruments. But whether anyone there actually knows where they are or how to use them, well, that's another question.

 

[Andy]

However, concerns should be verified using old school methods, if the user isn't happy. Our ED mostly uses electronic units, but there are manual sphygmomanometers available.

Be honest, the blood pressure monitor name was coined by Homer Simpson right?

 

[vreihen]

It also worth noting, that the small BP devices available at pharmacies, are usually wildly inaccurate, and shouldn't be used for diagnostic purposes!

Funny thing is the home-grade one that I have *will* get a pulse lock and give repeatable/believable output about 50% of the time. It took me a few sets of batteries tinkering with ways to "trick" it from over-inflating, since it doesn't see my pulse on the inflate cycle and just keeps on pumping away until the blood flow is cut off for too long to read on the deflate cycle. Before I figured it out, it couldn't get a pulse lock at all.

These things have their place, but clearly on YOUR arm isn't one of them :-)

I'm sure that Tim Cook would agree with that, since my fruit-watch reads my pulse at least 33% high compared with what the nurse is charting at the same exact time.

It DOES scare me that medical professionals may come to rely so heavily on technology, that they don't really keep their skills honed!

I wonder if you situation is related to legal issues and patient record storage etc?

I can tell you I know for a fact that they leave college with RN degrees, BP cuffs, and stethoscopes...and training to use them. I think that the problem is that our hospitals are employing minimum wage "grunts" who went to tech school for 6 months to earn a certificate in thermometer and BP machine operation, so that they don't have to pay real nurses to do these tasks any more.

During my last hospital stay about 3 years ago, I was assigned an RN student from a nearby university to serve as her clinical patient for the day. Working under direct RN supervision, she had to take all my vitals every hour, chart everything (including urine output), and even consult with my doctor about my diagnosis and treatments. She had to interview me about my illness, family history, and other medical problems, and write a whole summary up for her clinical grade. She couldn't find my pulse by hand or with her stethoscope, and even the supervising RN had problems. My primary care doctor stopped in for a visit as this was happening, and gave them the "doctor's grade" stethoscope to use because obviously the nurse-grade ones were not up to the task. The student heard the pulse with the better tool, and my doctor had to explain that my heart function was so weak that even experienced medical people can't hear it at times.....

 

[vreihen]

I bet the ER Art went to has manual backup instruments. But whether anyone there actually knows where they are or how to use them, well, that's another question.

The (male) RN that I was dealing with said that they did not have any manual instruments in the ER when I specifically asked about them, and he worked there long enough where he should know where they store the un-used junk. The place was remodeled since my last visit, and all of the equipment in every treatment bay is the latest bling with no old junk mercury BP thingy hanging in the corner.....

 

[Uwe]

The place was remodeled since my last visit, and all of the equipment in every treatment bay is the latest bling with no old junk mercury BP thingy hanging in the corner.....

Well, the 20% of GDP that the US spends on "Health Care" had go SOMEWHERE, right?

 

[vreihen]

Well, the 20% of GDP that the US spends on "Health Care" had go SOMEWHERE, right?

Actually, Bill Kaplan (philanthropist and founder of the AC Moore Arts and Crafts store chain) wrote the check for the ER upgrades, since the hospital is not-for-profit. Next time that I bump into him on the philanthropy social events circuit, I'm going to suggest that he fund a separate gunshot trauma wing so the hospital doesn't have to lockdown the entire ER for Newburgh's daily shootings.....

 

[Uwe]

the hospital is not-for-profit.

"Not-for-profit" doesn't mean there aren't dozens of "administrators" pulling down 6-figure salaries, does it?

 

[DV52]

The (male) RN that I was dealing with said that they did not have any manual instruments in the ER when I specifically asked about them, and he worked there long enough where he should know where they store the un-used junk. The place was remodeled since my last visit, and all of the equipment in every treatment bay is the latest bling with no old junk mercury BP thingy hanging in the corner.....

vriehen: I couldn't agree more with your observations - worst aspect is the medical fraternity's unswerving belief in the infallibility of whatever these machines say. It's worse than any fundamentalist religious zealot - made truly remarkable by the fact that these are meant to be intelligent people!!

Anyhow, just to present another side of this equation, I thought that I would show you my standby alternative for those times when technology fails - which it does with monotonous regularity!!

I always have my trusty "Fuller's Calculator" handy anytime time that I plug-in the HEX NET cable (see below)

I suspect that you are far too young to remember the "Slide Ruler" (it's not your fault). I'm old enough to have used one in my undergrad course (it was more modern than the device in the picture). This is just a version of the same thing, but with an extremely long spiral scale - makes it very accurate for sensitive engineering calculations!

I think the juxtaposition of the Fuller Calculator and the HEX NET somehow work well together!!

Don

PS: I hope that your good health returns with a vengeance (and not just a whimper)

 

[Uwe]

The chemistry class I took a year early in 10th grade ('73-'74) was the last one where students were taught the use of slide rules. I'm reasonably confident Art is familiar with them as well.

 

[PetrolDave]

I only threw my slide rule into the trash last month, after using it for 42 years!

 

[passim]

"Not-for-profit" doesn't mean there aren't dozens of "administrators" pulling down 6-figure salaries, does it?

Any IT person with 7+ years experience likely pulls 6 figures in major metro healthcare these days. I think it's many, many more dozens than you have in mind.

 

[Andy]

There's a website called Glassdoor that lets you look up salaries for many NFP companies:

https://www.glassdoor.com

For example:

https://www.glassdoor.com/Salary/Abington-Memorial-Hospital-Salaries-E17630.htm