FEATURE For The Digital Doctor, Wachter received sage guidance from his wife, Katie Hafner, who has written even more books than he (six) and who writes on health care for The New York Times. When he told her his idea, she replied, “The only way you’re going to get this story right, the only way it’s going to be interesting, is to go out and talk to people.” “As soon as I started doing that,” he acknowledges, “it was immediately obvious that she was right.” He interviewed 94 people (listed in the book), quarried his own experience, consulted history (tracing patient notes from their Greek origin to the present), and visited computer and other companies, physician practices, and hospitals, including his own, where the book’s centerpiece patient error occurred because of, not despite, the latest technology. Computers, Wachter concludes in The Digital Doctor, prevent some mistakes of the past but create new ones. The error he explores was the result of bad software and a glut of false alerts to patients’ situations, which lulled hospital personnel from paying proper attention to genuine crises. Computers have
also distanced doctors from patients as well as from each other. He argues for “a thoughtful use of technology.” For instance, better communication with software engineers for “user-centered design.” Most people are good people trying to do the right thing, he says, but things can go wrong when those involved see only through their own lens. Another recommendation: doctors should get their heads out of their computer screens and back to facing their patients. Enabling him to investigate and discuss a near-fatal error was “an act of incredible organizational bravery” on UCSF’s part, he says, and the feedback “has been universally good. It was the right thing to do.” “On the other hand,” he adds, “we got a letter from the Joint Commission saying, ‘Can you tell us a little more about it?’ — as if UCSF’s actions and standards were problematic. The Commission’s response “is a little disappointing,” Wachter says. “I would hope that the incentive system out there would be one in which this kind of thing is praised, because that’s the way we’re going to get better.”
A physician and a blogger, Wachter encourages “a thoughtful use of technology.”
FALL 2015
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