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Dr. John Henry

Elyas Bakhtiari, for HealthLeaders Media, February 28, 2008
Remember the story of John Henry? He was a folk hero, in the same vein as Paul Bunyan and Pecos Bill, who was rumored to be strongest man alive in the 19th century and the greatest steel driver to ever hit a railroad spike. He led the westward expansion of the railroad by drilling straight through the heart of a mountain, a venture that cost the lives of a thousand workers, the story goes.

He was a hero and unmatched in his talent, until a salesman came along with a steam-powered drill that he claimed could out-drill any human. Threatened by the new technology and concerned about his job and the jobs of his men, John Henry challenged the inventor to a contest--man versus machine.

This tall tale immediately came to mind when I read a story this week about a computer that is more accurate at diagnosing certain brain diseases than human doctors. Experts programmed a personal computer to diagnose Alzheimer's based on brain scans and achieved a 96 percent success rate, considerably better than the 85 percent accuracy by clinicians using standard scans, blood tests, and interviews.

I've seen similar reports about the success rates of more encompassing diagnostic software that is already available on the market, in some cases for free. Once symptoms are identified, diagnosing is very mathematical; it's a matter of calculating the possible diseases that correlate to the specific combination of symptoms, so it makes sense that a computer would be better able to quickly navigate this matrix.

But only a very small percentage of physicians have embraced these diagnostic tools. In many cases this is because of budgetary or technological constraints, but some claim there may be a psychological component to physicians' resistance. Research suggests physicians tend to be overconfident in their diagnoses and receive inadequate feedback about their diagnostic mistakes. Combine that with the financial pressures to see more patients in less time, and it's a testament to physicians' extraordinary talents that they are as accurate as they are.

But here's the interesting part: The same technological advancements that many physicians currently reject could help them overcome those financial barriers. Not only diagnostic software, but EMR sharing, online prescriptions, and other high tech tools that physicians have been slow to adopt can improve efficiency, patient satisfaction, and the quality of care if used to enhance, rather than replace, physicians' skills.

And that's the key. Physicians should view technology like diagnostic software as another tool in their arsenal rather than as a threat or a nuisance. John Henry's tale ended with a victory, but he won the battle, not the war. After giving every last bit of strength in his body to beat the machine, he collapsed and died on the railroad track.

No machine will ever replicate the doctor-patient relationship or replace the judgment, quick-thinking, and empathy that characterize all good physicians. But physicians who have been reluctant to embrace new technology would be wise to examine the reasons behind their hesitance, and take a lesson from John Henry.


Elyas Bakhtiari is a managing editor with HealthLeaders Media. He can be reached at ebakhtiari@healthleadersmedia.com.

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