COMMENTARY

Stuck in the Past: Why Are Doctors Still Using the Stethoscope and Manila Folder?

Michael Splinter Asks Why Physicians Haven't Adopted More Modern Technology

; Michael R. Splinter

Disclosures

December 10, 2013

The Manila Folder

The other anachronism in the doctor's office is the manila folder. Oh my God! Nowhere else in any industry would you keep a customer's profile in a manila folder. The folder could be lost or destroyed by any number of means. There is no data backup to the manila folder, and if you have been going to the same doctor for a while, that manila folder is pretty thick. The folder from one doctor doesn't travel with me and so all kinds of tests are needlessly repeated. Today, computerizing these records in a way that they can be analyzed, timelined, transmitted, and correlated is a very simple task. Every industry has done this automation for their customer base. It is medicine that stands alone in refusing to embrace even the simplest data technology. Again, with good data, so many mistakes could be avoided and early detection of problems discovered, avoiding serious complications with higher costs. Your personal data should pop up on an iPad when you walk into the office. Your doctor would not have to ask you when you had your last tetanus shot or if you are eligible for the shingles vaccine. She would know; it would be right there on the screen, and she could immediately focus on treatment and patient care.

So, what does a doctor need to enable improved and rapid diagnosis, and informed patient care, at the first point of contact, which would reduce the cost of medical delivery in a dramatic fashion?

-- Michael R. Splinter, Executive Chairman, Applied Materials, Inc., Santa Clara, California

Dr. Topol's Response

It is so refreshing to get an outside view on how we are stuck in our ways in medical practice. Mike has made the right diagnoses here. In many ways, the stethoscope can really be considered a relic, as the use of a pocket ultrasound device obtains far more information than just listening to sounds on the stethoscope. As Mike said, "stethoscope" is a misnomer-- it doesn't scope anything out; it is just a stethophone, and a weak one, as aptly critiqued above. And we all know that we need to move far beyond the manila folder era toward efficient health information systems.

This is all about the convergence of digital technology and medicine. In order to catalyze this transdisciplinary fusion, we need input from tech leaders. I think we have certainly found one here, and I am sure our readers at Medscape will find it quite an interesting perspective.

Eric J. Topol, MD
Editor-in-Chief, Medscape

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