Old Lad

Looking back I think I have tried to keep up with the IT revolution. It is quite extraordinary to realise that in thousands of years of our history this is probably one of the biggest quantum leaps humans have made – and in a relatively short space of time. I read recently of a museum hosting an exhibition of computing and looking at the various examples I could recognise my computer journey. It started with a Sinclair ZX81 – a useless gadget which only allowed you to play table tennis on a TV. I then progressed to an Amstrad word processor and was introduced to floppy discs (remember those?). My first proper PC was a Fujitsu desk top with a rather large box for the entrails, but it was a leap forward – still with floppy discs – and limited capability. I now have a laptop and an iPad and a smartphone. I still sit and remember as a medical student in the sixties, the Royal Infirmary in Liverpool had installed a computer – it took up a whole room, used reel to reel tapes and punched cards – remember those and you give your age away!

We oldies live firmly in the digital age and there is no going back – resistance is futile. For a long time I resisted a smartphone but eventually gave in and have to admit it has made life easier. I do find it useful to communicate with people, see the weather forecast, book train tickets and use the map to find my way round places. However I still have friends who are resisting the use of IT and see it as a badge of honour that they don’t use email or progress to a smart phone. It is exasperating and they remind me of people who resisted motor cars and wanted to stick with their horse and cart! I accept that the older we get the more difficult it is to learn new skills but with patience it can be done. Perhaps we need to help the small group of people who can’t do it and add some sort of digital helper to home care services. However as you will have gathered I am a digital enthusiast but the one area I have some reservations about is my own specialty as an ex GP. There are many aspects of good uses of IT in medicine – clear and accessible medical records, computerised prescriptions with built in safety features, access to technical information, the ability to enter data into a record remotely etc. However the bit that really worries me is that we dehumanise medicine. Although artificial intelligence is said to be able to diagnose conditions better than a doctor it has its limitations. Yes it can accurately scan an X Ray and pick up abnormalities, yes it can give an accurate probability that test results are normal and can sift through a list of symptoms and try and find linkages that will suggest a rare diagnosis. But part of the doctor patient relationship which I still feel is crucial ( and which regular surveys show people agree with) is the ability to talk with another sympathetic human being. And the skilled clinician still can use non verbal cues in a person’s demeanour that can be highly significant. There is still an old aphorism that “ The doctor is the cure”. The other big elephant in the room is that when systems crash or a major cyber attack occurs, chaos soon reigns. I know of several GP practices where this has happened and the doors were simply closed and telephone queries were met with a response that the computers were down and nothing could be done! In other words “The computer says No!” So I would say to my younger colleagues go carefully and don’t lose your interpersonal skills.

So to all the Old Lads and Lasses out there I would say embrace the digital revolution. It will make your life easier and also has the advantage that if you know how things work, you can challenge the occasional jobsworth who blithely says “ The computer says No”!