Are doctors ready for body cams?


Google Glass makes it into the surveillance society

Maybe you remember the famous video by Simons and Chabris. Two groups of students, one in white shirts and the other in black shirts, are passing a basketball around. You are asked to watch the video and count the number of passes made by one of the teams. You proudly count 13 (the actual number is 18). But what you didn’t notice, during all of your counting, was that midway through the video, a gorilla walked straight through the middle of the scene. Indeed about half of individuals tested in the original study missed the gorilla.

A red trauma victim is brought into the ED trauma bay by EMS. The lead paramedic provides details about the crash scene, the patient’s health status, and gives a point-by-point report about the prehospital care. Too bad that only 36% of the key information was accurately remembered by the receiving ED group.

What’s happening here?

These two examples highlight how medical care can be perceived differently, and maybe even contradicted, by doctors and patients. We aren’t aware of something we have missed — like the gorilla. You only see things you are focusing attention on. Have you ever had a patient complain “the doctor didn’t even examine my stomach” when you have performed, and documented, several serial exams? How many times have you been asked by a patient “When am I going to see the doctor?” when you’ve already had several conversations and introduced yourself as THE DOCTOR. Or, are perplexed by a family display of great disbelief when informed that their loved one is sliding towards the end of life.

We think we perceive and remember more of the world than we actually do, and different people experience the same inputs differently. We don’t see, hear, and remember alike. Hearing is passive, but listening requires concentration and focus to understand the meaning of another’s words.

Jeremy Brown has identified lots of examples where a med-cam can provide an objective view of medical reality — a sort of enhanced photojournalism — where the picture tells the truth. But we need to be ready to have our own behaviors and communications on display. After all, what’s good for the patient should be good for the doctor, too.

Questions of what’s private and what isn’t used to be decided essentially by what’s public and what isn’t. Starting with the obvious – like body cams for coppers – I can see where record-keeping is going. Not only for accurate answers to recurrent questions in an ER; but, the lawyers on retainer for the hospital are going to want this kind of recorded observation to keep a handle on liability.

The feeling changes. Your relationship with your employer changes. Doctors especially feel they’re part of the management team – even in large-economy-size urban hospital complexes. That feeling will change under observation. As much as useful qualities like those described in this article may be – in our society it’s easy to worry about office politics, petty jealousy becoming equally important to some administrator you consider to be an ignorant ass.

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