A recent press story about a Kaiser medical “robot” delivering a terminal diagnosis to a patient and his family has the internet officially outraged.
Where’s the compassion? Where’s the humanity? Clearly the robot Health 2.0 apocalypse is at hand!
But as is almost always the case with today’s click-bait headline journalism, there’s more nuance to this story than our “outrage culture” will allow us to easily see. Let’s not throw the telemedicine baby robot out with the robot bathwater.
So here are my thoughts in a quick video, and here’s a Fast Company article where I’m quoted about this story. WARNING: I’m taking the contrarian viewpoint here, so you might wanna fight me, bro.
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Hey, what is up Z-Pac. So about a million of you guys have sent me this article about the Kaiser robot that delivers a terminal diagnosis to a patient with end-stage COPD, and everybody’s outraged, and the outrage culture is fired up, and everybody on Twitter and Facebook is sending me this thing saying, “you need to express our outrage to the world.”
Stop for a second. Did you think, cause I did, when I read the article, that maybe there was more to the story than the press is reporting? Has the press ever gotten anything right when they report on healthcare stuff happening in the hospital? Why? Because the healthcare entities can’t respond immediately, because of ethics, we don’t talk about our patients, and because of HIPAA, we can’t talk about our patients unless they give us permission.
And so could it be that we’re missing the whole story. Here’s the story as it was reported: Patient gets admitted with end-stage COPD, goes to ICU, family’s there with him, robot comes in, gives him a diagnosis, “you’re dying”, walks out, family freaks out, goes to the press, this was terrible, no way to treat a human being, our dignity is robbed and end of life.
Is that what happened? No! Because Kaiser’s response, if you had read it, made it quite clear, and I had actually predicted this is probably what happened: They had had a meeting in-person with physicians, with the family, prior giving the prognosis and the diagnosis. The robot was simply a telehealth visit on wheels, with an actual human being on the other side, doing a follow up after hours.
Family was in the room, answering questions, that kind of thing. There was a nurse chaperoning this robot because that’s their rules at Kaiser, and they were using the machine like telehealth is intended to be used, as an extension of a human relationship.
When we were running Turntable Health, we used telehealth in addition to our in-person visits to extend our ability to deliver compassionate care. It was still a human relationship, just a different mechanism of communicating. It is not some empathy robot designed to replace us, but that’s what sells clicks in the press.
Now, the family went to the press and they were upset. Did they have a bad experience? Sure, and you can understand why. End of life diagnoses are hard on the best of days, and it takes multiple sittings down to get it through, so probably this was the second or third when the robot came in, and they were upset because they got this feeling that this was not appropriate, and that’s okay, that’s the patient experience.
But does that mean that we throw out telehealth, does that mean that we vilify Kaiser and the healthcare team taking care of these patients. Listen, tele-ICU can save lives and has, particularly in rural areas. If you’re smart, you don’t use it obviously to deliver the first news of a terminal diagnoses, but how about this, how about there are no doctors in the hospital, and it’s either that or don’t get the news.
You know, we have this false equivalence that well, it’s either this or this, sometimes it can only be one thing because we are limited for resources. There aren’t an unlimited number of doctors, in fact, we have a shortage, particularly in rural areas.
So here’s the thing, the next time you see a news headline designed to trigger outrage, you can think about it, you can learn from it, but I want you to think for yourself, you don’t need me to tell you how to think about this article. Look through, think about your own experience in the hospital and think about what could really be going on before you jump to conclusions, and then you can have an educated discussion about how this might help improve healthcare, bring about Health 3.0, and get to the chase, which is, we need to resolve a broken system collaboratively, not with outrage and fear mongering, and nonsense that the press is really good at.
Alright, that’s all I got. Share this with somebody who shared that article with you, and tell em’ yeet yeet, I have no idea what that means, but I heard Logan say it once, we out.