Melvin Konner, PhD, MD, professor of human biology and medical anthropology at Emory University, was quoted in a 2001 Newsweek article titled “The Downside of Medical Progress.” Speaking as a patient, he said, “technology can come between us and our doctors who may be afraid to talk to patients and their families and even more afraid to touch them. Doctors are rarely sued for applying high technology but are often sued for omitting it.”
Herb Fred, MD, editor of the Texas Heart Institute Journal, states, “I have watched the progressive demise of bedside medicine. Our reliance on technologic marvels has crippled physicians’ use of their minds and their sensory faculties to make diagnoses.” He further states, “This new way of practicing has made the skilled clinical diagnostician a vanishing species. Not only has it taken the ‘fun’ out of medicine, but it has depersonalized the patient-doctor relationship and eliminated the individuality of patient care.”
Fritz Bamgartner, MD, of Vascular & General Surgery Associates in Los Alamitos, Calif, also writing in the Texas Heart Institute Journal, elaborates on the “chasmal disconnection between the barrage of technology with which the ‘techno-doc’ assaults his (or her) patients and the genuine hands-on touch and concern truly humane doctors have for their patients.”
Most family physicians and internists don’t see their patients if they are hospitalized, further de-emphasizing the value of the hands-on healing touch. A hospitalist who has never seen the patient previously communicates with the family doctor via the phone or email. This can be very disconcerting for patients, especially young children and the elderly.
A discussion of bedside manner and the important role it plays in the ever-changing world of medical technology is relevant for dentists as well. From the time we start dental school, through the next 4 years, and even if we pursue advanced specialty training, we are immersed in a world of learning to become skilled in performing clinical procedures and treatments.
But sadly missing from this world is a sense of what our future patients expect of us. Of course, they assume we have the technical skills. But what we don’t realize is that the average patient is just as concerned about how much we care as how much we know.
People suffering with serious and even terminal illnesses consistently express their gratitude for the empathy that a truly caring doctor, nurse, or other caregiver provides. For our purposes, let’s address some examples of specific items that tend to enhance or damage the traditional doctor-patient in relationship in the face of pressure to utilize one of an array of high-tech advances.
First, there’s the Internet. For all the good that easy access to information on Google, Facebook, Twitter, Instagram, email, text, or an office website provides, it does not take the place of one-on-one interaction, the sound of your voice, a shake of your hand, a feel of the touch, and the warmth of the smile contact with the patient.
Next, just to emphasize the fact that the doctor does not want to talk to you, we have the “don’t bother us” answering machine. If this is an emergency, dial 911. If you know the extension of the person you’re calling, dial it now. If you’re calling about your bill, hit 2. If you’re calling about your prescription, hit 3. If you’re calling to make or cancel an appointment, hit 4. If you’d like to speak to to Irma, the office manager, hit 5. If you’re calling to speak to the doctor, good luck.
And of late, various medical authorities have commented on mammograms, PSA tests, MRIs, and CAT scans that are recommended because the doctors are being defensive about their diagnoses, not because they are what the patient truly needs. On the one hand, we can be thankful about the lives these technologies have saved. But sometimes, too much information can cause unnecessary patient anxiety. The wonder and value of looking at a 3-D radiograph cannot be denied, especially if you’re contemplating the extraction of impacted third molars. But often, the less costly panoramic view can provide sufficient information.
Of course, there are some other interesting technologies that are disrupting the way we practice and improving the care we provide—as long as we don’t lose sight of the importance of dentist-patient communiation. For example, Dentsply Sirona’s CEREC technology creates digital impressions via digital scans combined with a milling unit. Along with CAD/CAM equipment, it could be used to construct and deliver a ceramic crown in a couple of hours. This technology has changed the world of restorative dentistry.
Cari-Vu is a new, portable infrared transillumination unit from Dexis that provides a quick, noninvasive look at the interproximal surfaces of the teeth to give dentists a heads-up in regard to early carious lesions. Suspicious areas then could be observed more closely with radiographs. (We just ordered a unit for a trial run in our office.)
In experimental stages now, in Israel, robots are preparing posts for implants. A frame is clamped on the mandible with needles pointed at the desired area of the bone. A drill bit assembly hovers over the area. With the press of a button, the drill enters the bone and prepares the opening for the acceptance of the implant.
These examples just scratch the surface of the lack of awareness some dental practitioners have when it comes to communicating concern and empathy for their patients. We need to spend more time working on our chairside manner as a most valuable adjunct to our clinical expertise. Our patients deserve it.