Currently, I am a medical writer for clinical trials. The human aspect of my job is hard to ignore considering that I am writing about subjects' immunology and safety results. However, a recent New York Times article took me back to my earlier days of working as a medical technologist in a hospital microbiology laboratory; a time when the human aspect was not always present.
As a technologist, I spent many hours processing serum samples through machines, and, at times, feeling like a machine myself. In other respects, I had to force myself to de-humanize the certain samples due to their inherent nature. For example, I would pretend that stool samples were actually mud; however, it was difficult to keep the mental image of mud when that mud also contained corn.
The main point is the fact that the job duties became extremely mechanical in nature. The workload was high, and the manpower was low. Therefore, tasks must have been performed efficiently without extended thought, and it was very easy to forget about the human aspect of the job.
Dr. Yehonatan Turner, a radiologist from Jerusalem, appears to have the same problem in his field, but he thinks that he has come up with a solution.
When Dr. Turner began his residency in radiology, he was frustrated that the CT scans he analyzed revealed nothing about the patients behind them. So to make things personal, he imagined each patient was his father. But then he had another idea; to attach a photograph of the actual patient to each file.
Dr. Turner’s hunch turned into an unusual medical study. Its preliminary findings suggested that when a digital photograph was attached to a patient’s file, radiologists provided longer, more meticulous reports. And they said they felt more connected to the patients, whom they seldom meet face to face.
In the digital age, adding a photo to a file is a simple procedure, and the study’s authors say they hope it becomes a standard procedure; not just for radiologists, but also for pathologists and other doctors who rarely have contact with patients.
However, attaching photos to patient files could prove difficult in the United States. Privacy rules might require patient consent each time a photo was used.
Putting aside any ethical implications concerning privacy, the logistical considerations alone should be enough to thwart any thoughts of this photo system. Who supplies the photo? Would photo costs be covered under health insurance? What is done with the photos after a X-ray is processed? Would healthcare institutions need a separate filing area for all of these photos?
While Dr. Turner's heart seems to be in the right place, I think that his passion for photography and art should remain separate from his radiology career. I mean, where would the photograph madness end? If I were still a medical technologist, would I want to see the face of the patient's stool that I am plating?
I think the answer is that each individual in the medical field should take it upon themselves to find their own human inspiration behind mundane and mechanical tasks. For me, it was my once week expeditions out of the microbiology lab. I volunteered to be the individual to maintain the bloodgas machines in the Intensive Care Unit. If seeing people dying doesn't make you see the human aspect, then you're definitely in the wrong business.
BW706 Blog #11
Lisa Menard
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4 comments:
Hi, Lisa, that's a great blog. I would like to add my own personal experience to the photograph concept. I am a Quality Assurance-Good Clinical Practice (QA-GCP) auditor for a pharmaceutical company. I was recently auditing an investigator site for an oncology clinical trial and each patient's file contained a facial photograph of that patient. It became a somewhat emotional undertaking for me to review these files because of the ultimate endpoint of death for each of these patients. Every one of them died and each one had a story. I had my impressions of what their personalities were like and the files also described some of their personal lives. Some were the same age as me, which struck home the inevitability of death and the preciousness of life. Seeing the photographs didn't much affect the conduct of my audit but I can concur that if I were a technician who never met these patients it would certainly make me more careful in handling their x-rays or specimens or whatever. I think Dr. Turner's passion for art is what makes him a great doctor - he should definitely not stop because that works for him. Other health field workers should be inspired by his work and find their own way to humanize what can often become dehumanizing situations for the patients involved. I think the same HIPAA rules would apply for the taking of photographs - as long as they are not sent off-site and the photographs treated as any other confidential information, there would be no infraction of the rules. And patients could agree or disagree to have their photos taken, which could easily be done straight from the intake coordinator's computer. I agree that there should be limited use of such photographs - perhaps just for radiological readings and other imaging for cancer screening or other serious illnesses, where an accurate reading could spell the difference between life and death.
I need to qualify some of my statements in the previous comment: Dr. Turner's passion for art is part of what makes him a great doctor. Of course, there are other factors involved. Doctors in the past had a very strong foundation in the humanities - philosophy, art, and literature. I think that made for better doctors and probably helped to spur some of the more creative advances in medicine.
Although seeing the photographs didn't change the conduct of my study, I do remember that I did actually scrutinize the subjects' charts a little more deeply after feeling a personal connection to them. It brought home to me the reality of why I was doing what I was doing.
What's really sad to me is that so many practitioners don't always take the care they should with the real people that are in front them. I wonder if attaching a photograph to them would help any?
A photo would be a good idea in some cases, because when we see a picture, it adds more feeling to what you are doing. It's like the whole package is coming together. Although, some patients might be embarassed about it because they don't want their face to be on every chart that has their name on it. Plus a lot of people handle hospital charts. I did a clinical rotation half a year where all we did was look at charts and while we were SOAPing, there were nurses, attending physicians, pharmacists, and other personnel who were authorized looking through the charts, I mean if I was the patient I would have felt uncomfortable. Plus,without a face you still have that feeling of anonymonity, which gives you a little security. Also what if putting a photo on a chart, might encourage discrimination, I mean who knows what goes on in people's minds. Plus, the photo idea throws the whole patient confidentiality out the window. Even if you don't remember personal facts by itself, you'll remember the face and facts will tag along whether you want it to or not.
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