Do Decision Support Tools Make Docs Look Dumb?

Gienna Shaw, April 19, 2011

While interviewing sources for my story on evidence-based medicine for this month's issue of HealthLeaders magazine, one surprising sentiment came up over and over. The healthcare leaders and industry experts I spoke with said some docs don't like decision support technology because they think it makes them look dumb.

When face-to-face with a patient, these sources say, docs don't want to seem reliant on finding the answers on a computer. Is it true?

Well, one study suggests that it is. In the study, researchers read various scenarios to waiting room patients about physicians who used decision support and heeded the recommendation or ignored it in favor of a less aggressive or more aggressive treatment. Participants in the 2008 study, published in the journal, Medical Decision Making, "always deemed the physician who used no decision aid to have the highest diagnostic ability" on a five-point scale, the researchers said.

James Wolf, an associate professor of information systems at Illinois State University's School of Information Technology who studies physician adoption of—and resistance to—technology, saw similar results in his most recent studies. In one, even tech-savvy undergraduate and graduate computer science students preferred physicians who rely on intuition instead of computer aids.

"Patients object when they ask their doctor a question and then she or he immediately types in the question into their laptop and then reads back the answer. It gives patients the feeling that they just paid a $25 copay to have someone Google something for them," Wolf says.

And that perception, in turn, worries doctors. "Physicians are reluctant to adopt computer-based diagnostic decision aids, in part, due to the fear of losing the respect of patients and colleagues," Wolf says.

I'm not buying it.
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