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Curbside Consult with Dr. Jayne 9/3/12

September 3, 2012 Dr. Jayne 4 Comments

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This weekend on HIStalk Practice, Dr. Gregg wrote about the possibility that the “infamous tricorder from Star Trek” is about to become reality. A company called Scanadu has a prototype handheld diagnostic device that (at least according to their website) will debut in a little over a week. Although I agree with Dr. Gregg that it has huge potential to empower consumers with auto-diagnosis tools, I really have to wonder about the entire premise.

Their trailer video is quite engaging. They walk through a parent diagnosing their child’s rash, a mom receiving a warning about a whooping cough outbreak and the fact that her daughter needs an additional immunization, and parents diagnosing their sick child with a potential urinary tract infection and being sent to an urgent care facility. The voiceover states, “We’re building a way for people to check their bodies as often as they check their e-mail.”

Like so much today, some technology is surrounded by a lot of hype. While I don’t doubt that this is going to be a very cool and potentially powerful technology, I have some concerns with it. It feeds into the idea that we just have to embrace technology and we will live happier, more fulfilled lives.

I’m betting most Americans will hope that at the end of the diagnostic algorithm, it suggests a single pill that can fix everything. Just a few seconds of scanning a day will convince us that everything is OK.

Guess what? It’s not OK. Americans are fatter and more unhealthy than ever. We don’t need any miracle technology to tell us this. There are simple things we can do every day for our health that we are simply unwilling to do because they’re not sexy or high tech. They’re hard work and involve difficult choices and possibly sweat.

Physicians and other health providers have been preaching these things for years, yet people do not follow these recommendations. Will it make a difference if the recommendation comes from an impersonal device? I doubt it. I’m willing to keep an open mind, though, if there is even a small chance it will make a difference.

I’d like to live in an age where people are as obsessed about their body mass index as they are about finding out what Snooki named her baby. An age where people sit around the pub comparing their best fitness data instead of the statistics of their fantasy football teams. An age where I never have to diagnose another child with diabetes.

The folks at Scanadu have a great tagline: We are the last generation to know so little about our health. I really don’t think that’s true. I think we know a lot about our health. We’re just unwilling to do anything about it.

I look at my thousands of co-workers at Big Hospital. We all have to check our biometrics every year in order to get the best discount on our health insurance premiums. But looking at our population as a whole, having this information hasn’t led to a tremendous cost savings or healthier employees. People know their numbers, but they simply don’t care. They don’t want to give up habits or behaviors they find pleasurable. They haven’t come to grips with the fact that in the end, it’s a zero-sum game. Unless you’ve won the genetic lottery, each of us has to pay for our dietary and exercise indiscretions.

Being a physician doesn’t make me any better than the next guy. I have weak spots for chocolate and martinis. Those who know me really well know that I also have a thing for Buffalo chicken wings and all things fried. I love to watch bad TV and once became nearly vegetative watching a marathon of Deadliest Catch.

At the opposite end of the spectrum, I work with residency faculty members whose most indulgent meal is a baked potato with some olive oil and spices. They may get by on that, but I know that ultimately I am going to make less than perfect food choices and I’m going to have to balance it out with healthier meals at other times and also with daily exercise. I don’t take my health for granted – none of us should.

Technology can be a great motivator to help people track their health. I love reading HIStalk Mobile and seeing all the cool trackers and apps that Dr. Travis finds. I’ve even tried some of them. Recently a community group I’m part of decided to take part in the Presidential Active Lifestyle Award challenge. We created a group where we could log our activity and track some group goals as a motivator. As a community group that mentors youth, the adults have a vested interest in making healthier lifestyle choices so we can serve as role models.

After two months on the challenge, we have exactly four people who are willing to go online and log their activity, and only two of them are actually active. It’s a sad commentary. (I have to think we’d have better participation if The President’s Challenge had a mobile app, but alas, they do not.) Today I can’t even log in. We can put a man on the moon, but we can’t handle our exceptions, apparently.

I’m looking forward to seeing what Scanadu has in store for us. Having served on the sidelines for youth sports teams, I’d love a hand-held scanner that can help me determine the prognosis for a concussion or whether that student with mononucleosis really has an enlarged speen and needs to sit on the bench. As someone who cares for children, I’d love something that can reassure a parent when their toddlers slip in the tub and hit their heads. I’d be thrilled with any handheld device that can actually get people excited about their health and convince them of the need to eat less junk and move their bodies regularly. Unfortunately, I’m just a little bit skeptical at the moment.

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Currently there are "4 comments" on this Article:

  1. “They haven’t come to grips with the fact that in the end, it’s a zero-sum game”

    but it’s not – you’re going to die – probably horribly – however you live. In fact, since going by heart disease is nicer than cancer, then you could argue that living it up (or eating it all up) is a rational response. (And heart disease is cheaper than cancer too)

  2. Dr. J –

    Don’t get me wrong; I’m filled with skepticism amidst this overpromising/underdelivering HIT world. Yet, I continue to hold out hope and look at the half full side. I mean, cripes, when I was a kid, the only big screen TV that I ever saw was on the Star Trek bridge! Things can change.

    I fully agree that tech for tech’s sake won’t change anything. But just look at how truly user-friendly tech has changed how we communicate, how we access information, how we share.

    I’m sure Scanadu will undergo numerous iterations, but I’ll bet you a month of chocolate martinis and a boatload of Buffalo wings that some variation thereof will be an essential part of everyone’s personal first aid kit in the not-too-distant future…

    …is it a wager? 🙂

  3. How about a low tech bathroom scale? People can find their weight for free anytime, but that information doesn’t seem to produce much weight loss.

  4. BehaviorChangeGuy – you’re so right about the bathroom scale not being enough to actually promote change. My spouse has stepped on one for years, second thing every morning without fail. Since there has been no change in her over-weight, I’ve asked her, “What is this long-standing ceremonial practice actually getting you? Could it be that the stress and guilt you must surely feel in not seeing even the slightest weight loss, in spite of your continued best efforts, is actually worse for you than if you never checked your weight in the first place?”

    She thanked me for my helpful observation, and eventually agreed to drop the divorce proceedings… and I agreed to use next weekend to patch a hole in the wall that’s roughly the size of.. oh.. a blow dryer.







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