Robert M. Wachter > Quotes

“One of the great challenges in healthcare technology is that medicine is at once an enormous business and an exquisitely human endeavor; it requires the ruthless efficiency of the modern manufacturing plant and the gentle hand-holding of the parish priest; it is about science, but also about art; it is eminently quantifiable and yet stubbornly not.”
― Robert Wachter, The Digital Doctor: Hope, Hype, and Harm at the Dawn of Medicine’s Computer Age

“a famous 1925 lecture given by Professor Francis Peabody to the Harvard medical student body:             The good physician knows his patients through and through, and his knowledge is bought dearly. Time, sympathy, and understanding must be lavishly dispensed, but the reward is to be found in that personal bond which forms the greatest satisfaction of the practice of medicine. One of the essential qualities of the clinician is interest in humanity, for the secret of the care of the patient is in caring for the patient.”
― Robert Wachter, The Digital Doctor: Hope, Hype, and Harm at the Dawn of Medicine’s Computer Age

“I hope you're appreciating the rich irony here: hospitals and doctors are using the Medicare subsidy (Medicare is the federal agency that doles out the HITECH dollars) to buy computer systems that allow them to bill Medicare more effectively.”
― Robert Wachter, The Digital Doctor: Hope, Hype, and Harm at the Dawn of Medicine’s Computer Age

“James Reason reminds us, “Errors are largely unintentional. It is very difficult for management to control what people did not intend to do in the first place.”
― Robert Wachter, Understanding Patient Safety

“The modern patient safety movement replaces “the blame and shame game” with an approach known as systems thinking. This paradigm acknowledges the human condition—namely, that humans err—and concludes that safety depends on creating systems that anticipate errors and either prevent or catch them before they cause harm. Such an approach has been the cornerstone of safety improvements in other high-risk industries but has been ignored in medicine until the past decade.”
― Robert Wachter, Understanding Patient Safety

“Smart Patients and other online communities are demonstrating that patients can learn a tremendous amount from one another.”
― Robert Wachter, The Digital Doctor: Hope, Hype, and Harm at the Dawn of Medicine’s Computer Age

“Emergency department physicians spent 44 percent of their time entering data into electronic medical records, clicking up to 4,000 times during a 10-hour shift. —Becker’s Health IT & CIO Review magazine, October 11, 2013”
― Robert Wachter, The Digital Doctor: Hope, Hype, and Harm at the Dawn of Medicine’s Computer Age

“As Stravinsky says, art is nothing more than placing limits and working against them rigorously … and if we refuse to place them … you do not have art, you have chaos, and to a large extent that’s what we’ve had.”
― Robert Wachter, The Digital Doctor: Hope, Hype, and Harm at the Dawn of Medicine’s Computer Age

“If you do a single thing—and especially if there is a lot of money in that single thing—you should put a ‘Welcome, Robots!’ doormat outside your office,” wrote technology expert Farhad Manjoo in Slate. “They’re coming for you.”
― Robert Wachter, The Digital Doctor: Hope, Hype, and Harm at the Dawn of Medicine’s Computer Age

“if Watson is going to replace any physicians, it will likely be at the low end of complexity—for”
― Robert Wachter, The Digital Doctor: Hope, Hype, and Harm at the Dawn of Medicine’s Computer Age

“The Innovator’s Prescription,”
― Robert M. Wachter, The Digital Doctor: Hope, Hype, and Harm at the Dawn of Medicine’s Computer Age

“If we go into the visit with both parties knowing what’s going on, then we can spend the visit talking about what we do about it.”
― Robert Wachter, The Digital Doctor: Hope, Hype, and Harm at the Dawn of Medicine’s Computer Age

“Doctors think they are more important in their patients’ lives than their patients do.”
― Robert Wachter, The Digital Doctor: Hope, Hype, and Harm at the Dawn of Medicine’s Computer Age

“But laboratory, radiology, and pathology results were computerized relatively early (many hospitals and clinics did so in the 1990s), and some healthcare systems began experimenting with giving patients access to them.21 While this information was less fraught than doctors’ notes, many in the medical establishment still worried about how patients might handle seeing such results unfiltered.”
― Robert M. Wachter, The Digital Doctor: Hope, Hype, and Harm at the Dawn of Medicine’s Computer Age

“McGlynn EA, Asch SM, Adams J, et al. The quality of health care delivered to adults in the United States.”
― Robert Wachter, Understanding Patient Safety

“to tackle the problem of healthcare costs effectively, we’ll need a system in which “everyone is practicing at the top of their license.”
― Robert Wachter, The Digital Doctor: Hope, Hype, and Harm at the Dawn of Medicine’s Computer Age

“more data-driven, automated healthcare will displace up to 80 percent of physicians’ diagnostic and prescription work.”12”
― Robert Wachter, The Digital Doctor: Hope, Hype, and Harm at the Dawn of Medicine’s Computer Age

“Organizational factors that unlock the value of IT are costly and time consuming,” Brynjolfsson and a colleague wrote in 1998. “For every dollar of IT there are several dollars of organizational investment that, when combined, generate the large rise in measured firm productivity and value.” This means that an organization’s capacity to avoid treating its IT implementation as a “one and done,” and to keep investing and evolving, is what ultimately determines the outcome.”
― Robert Wachter, The Digital Doctor: Hope, Hype, and Harm at the Dawn of Medicine’s Computer Age

“We have Dragon [dictation software],” one primary care doctor said, “which you have to be careful of, because I just [dictated] ‘Patient’s prostate is bothering him’ and it turned out ‘Patient’s prostitute is bothering him.”
― Robert Wachter, The Digital Doctor: Hope, Hype, and Harm at the Dawn of Medicine’s Computer Age

“I hate the goddamn system, but until someone comes along with some changes that make sense, I’ll stick with it. —Clint Eastwood as “Dirty Harry,” Magnum Force, 1973”
― Robert Wachter, The Digital Doctor: Hope, Hype, and Harm at the Dawn of Medicine’s Computer Age

“All the technology in the world is not going to help you if it’s not intuitive and if the end user can’t use it.”
― Robert Wachter, The Digital Doctor: Hope, Hype, and Harm at the Dawn of Medicine’s Computer Age

“many people criticize Meaningful Use and HIPAA for being too much and too rigid, others criticize the ONC for being too lax in certain areas. The”
― Robert Wachter, The Digital Doctor: Hope, Hype, and Harm at the Dawn of Medicine’s Computer Age

“And for a personal health record to be truly transformative, it will need to be far more than a passive window into the medical record, with a scheduling and medication refill module tacked on. It will have to be dynamic, engaging, and capable of interacting with patients and families in ways that ultimately lead to better health. While Google and Microsoft were trying to find ways to give patients direct access to their records via the Web, others have focused on what might seem to be an easier problem: sharing records between”
― Robert Wachter, The Digital Doctor: Hope, Hype, and Harm at the Dawn of Medicine’s Computer Age

“Automation does not simply supplant human activity but rather changes it, often in ways unintended and unanticipated by the designers. —Automation experts Raja Parasuraman and Dietrich Manzey, 2010”
― Robert Wachter, The Digital Doctor: Hope, Hype, and Harm at the Dawn of Medicine’s Computer Age

“there is no guarantee that the time freed up by our newfound technological efficiencies will be made available for the human touch. A look at the modern history of industrial computerization would have one lay odds that this squishy stuff will be precisely what is sacrificed on the altar of productivity, particularly once every word, touch, and minute is measured, analyzed, and priced out.”
― Robert Wachter, The Digital Doctor: Hope, Hype, and Harm at the Dawn of Medicine’s Computer Age

“You’ve probably played that parlor game in which you fantasize about what it would be like to have a drink with one of the great figures in history. Perhaps”
― Robert Wachter, The Digital Doctor: Hope, Hype, and Harm at the Dawn of Medicine’s Computer Age

“Burton’s observations on the surgery service reflected this haphazard abundance. The NPs had to log in to 11 different information systems—an OR scheduling system, a separate clinic scheduling system, an outpatient medication system, and so on—to gather what they needed. This digital Easter egg hunt required more than 600 clicks, accompanied by more than 200 screen transitions. Besides the sheer insanity of the enterprise, the problem is that with each screen flip, your brain must process the new visual information—which generates the neuronal equivalent of the brief static you sometimes see on the TV screen when you’re channel surfing—and before long, all of your cognitive bandwidth is exhausted. He recalled a few cases in which the NPs missed obvious things, like a significant fall in the blood count, because “all they’re doing is foraging for information, writing it down, not even paying attention.”
― Robert M. Wachter, The Digital Doctor: Hope, Hype, and Harm at the Dawn of Medicine’s Computer Age

“Patients possess a body of knowledge about themselves that we can never hope to master, and we have a body of knowledge about medicine that they can never hope to master. Our job is to bring these two groups together so we can serve each other well.”
― Robert Wachter, The Digital Doctor: Hope, Hype, and Harm at the Dawn of Medicine’s Computer Age

“Civilization advances by extending the number of important operations which we can perform without thinking about them. —Alfred North Whitehead, An Introduction to Mathematics, 1911 During my visit to UCSF’s seventh-floor satellite pharmacy, I saw the pharmacists verifying many medication orders. A”
― Robert Wachter, The Digital Doctor: Hope, Hype, and Harm at the Dawn of Medicine’s Computer Age

“people working collaboratively with technology are far more effective than either people or technology alone.”
― Robert Wachter, The Digital Doctor: Hope, Hype, and Harm at the Dawn of Medicine’s Computer Age