There is a problem. It's a problem for me every day. The problem is technology, particularly for those working in healthcare. We want reliability. We don't have it. We want things to work in the future. They don't. We still use fax machines. We still use fax machines because they break but in reliable ways.
I don’t want product updates. I want a product that works and I don't have to learn to use it differently every week. I like new features and video games. But I don't like them in my healthcare software.
We learned to use things like scalpels. We learn to use stethoscopes. We learn to read MRIs. These things go through the FDA. They need to be rigorously tested before they get to us. And that means they don't change very often. We learn to use a set of tools, and we get good at it.
I wear Converse. I've worn Converse every day for about a decade. The reason I wear Converse sneakers every day—literally for a decade—is that I started wearing them as a child psychiatrist training at Bellevue, and I noticed that kids mention the shoes. And then I noticed a pattern: they mentioned within the first moments of the interview, and that was in 40% of cases. The rest will mention the shoes by the end of that initial encounter.
If you don't mention the shoes, and you're a kid, you have autism or schizophrenia until proven otherwise. That's what I learned from Converse as a shoe, every day, for over a decade. I don't know the pattern with any other shoes. If I wore other shoes to work, I would be without this crucial piece of information. I even like to wear the shoes socially, because I know the pattern.
This has nothing to do with Converse as an actual shoe for the purpose of helping me walk. They're crappy sneakers. They don't work very well. They fall apart after not too long, they're neither durable, nor are they particularly supportive. They are the fax machine of shoe wear. One of the things that they do, reliably, is give me information about the work I need to do as a psychiatrist. I need the pattern.
I'm a giant pattern recognizing machine. I wear the same shoes every day, just like a cardiologist might use the same stethoscope, so that our pattern recognizing skills are calibrated to the tools we are using. For me, their sneakers, for a surgeon, they might be a particular view on the MRI, or particular scalpel, etc. We all learn to use the tools we use regularly. So too, with technology.
So, for people making software for doctors, we're very particular. Because we learn in patterns. We learned to learn patterns. We are beholden to our patterns. They let us know when some things is different. So one of the reasons software, even if it sucks, even if it has a terrible, user interface, is so sticky and healthcare. We want to use the same thing in a pattern, that works in a pattern every every day.
Software updates break that pattern recognition. Stop updating the software. Stop it. I don't care if it doesn't work. I don't care if it's hard to use. I care that it's the same hardness as it was yesterday. You have to make software that's so much better, and all at once, because I don't want to incrementally learn a little bit by bit, I want to learn how it's broken and work around it just like I do with people.
Stop, please god, updating my software. Thanks for listening, no one in particular.
Upcoming events!
Eventbrite Tickets Link
…Next, I’m Appearing at…
May 7th at ATA Nexus in Phoenix!
Tickets Link.
May 15-16, Miami Beach + Virtual
Join me as I proudly co-chair the Summit on Breakthrough Therapies for Addiction, taking place May 15-16 at Mount Sinai Medical Center Miami Beach and live-streamed online. We will share research and expertise on treatments like psychedelics, non-hallucinogenic compounds, interventional brain medicine, neuromodulation, VR, EMDR, GLP-1s, and more.
Use discount code OM15 for 15% off today by visiting https://bit.ly/3vgLlZy.GP
And then…A Virtual, on June 5-7th!
Nicely said.
The solution is structured data at the point of care.
Near Realtime documentation at the point of care.
Near Realtime coding too.
Clinicians can focus on patterns then map them to data that becomes normalized.
Thoughts?
Love your insights. I’m a fellow MD working on the other side, the side of those who conceptualist and design the systems. I’d love to read a piece where you delve in detail in how you have negative experiences with your software updating. I’ve never experienced that in my medical practice, but my clinic mostly relies on paper-based records