Why Nurses will Outlast Doctors

Posted by in Musings




Yep, you read that correctly.  But for emphasis, I spell it out again in full detail….I believe that given the current state of the medical profession, and the increased role of technology within medicine, I believe the nursing profession will prove to be more important than doctors, and therefore survive as a career much longer.

I know that sounds extremist, but I absolutely believe it to be true.  And in order to further prove my conviction, I must make the surprising disclaimer that I AM GOING TO BE A DOCTOR!  In fact, I start medical school in 1 month.  So why on earth I would ever say such an outlandish claim, especially since I am degrading my personal aspirations?

First, I’ll admit I’m making generalizations for shock value.  Essentially I’m making the generalizations that nurses represent the “human element” while the doctors represent the “prescriptive element.”  Both are essential for proper healing.  Obviously it is essential to properly diagnose the patient and prescribe the best available treatment.  However it’s equally important, and often overlooked, to address the emotional and mental needs of the patients and those affiliated with the patient.

The Fall of (Traditional) Doctors

The vast majority of medical school is spent teaching EVERYTHING there is to know about human physiology, pathology, and how every aspect of human biology, from the micro to macro level, is interconnected.  There are so many possible variables that one must account for (e.g. age, weight, gender, patient history, etc.) that it does take years for any person to grasp the important details and properly diagnose a case.  But in reality, medicine is essentially , a decision matrix.  It’s insanely complicated; it continues to become more complex as more information, such as bioinformatics and genetics are being incorporated, but it’s a matrix nonetheless.

Soon, with the processing power of computers, this massive amount of medical knowledge can be stored into highly complex computer algorithm.  Conceivably a person could use a touch screen to parse through many symptoms, input their corresponding answers, while also providing pee, blood and skin samples.  Then the computer could calculate, with a high degree of certain, what the possible cause is.  (Which in reality is no different than the template throw which doctors diagnose today.)

The computer of the future will be also able to make correlations that would go beyond current doctors abilities, such as finding previously undocumented correlations.  With the entire database of man’s current knowledge of medicine, combined with the latest developments in research, computers with enough computing power could parse through hundreds of years of information in seconds. It is predicted that by 2045, the Singularity moment will have been reach.  This date marks the day a $1000 computer will have the computing power of the ENTIRE human race.  Imagine what a computer like that would be capable of doing?  If computers can diagnose ever patient, why would we need doctors?  (And let’s be honest, we’ve all had a doctor that is less agreeable than even our most stubborn of computers.)

Human vs. Prescriptive 

Doctors spend so much time on the “prescriptive element,” often the “human element” is forgotten.  Look at the admission process.  The most important pieces of information are GPA, the MCAT score (standardized medical exam), and the fulfillment of certain class requirements.  There have been efforts to make doctors more human, as opposed to “insufferable know-it-alls who bully nurses and do not listen to patients.”  And yes, Medicine HAS comes leaps and bounds in this matter, but just seeing it personally, I think it still lacks.  I mean, how hard is it to just be personable?!?

For over a year, I volunteered in the cancer world within the hospital, and I’ve seen this dichotomy of service in real time.  Given my limited role as a volunteer, most of my time was spent simply talking to patients; I tried to provide a friendly face, yet someone who understood their plight, and could just be a friend to talk to. Through my talks, most patients complaints came from their interactions with doctors. The nurses, who spent by far more time with each patient, all received glowing reviews. Why is this?  Is the the amount of quality given?  Or is it something more inherent in the perceived relationship between the patient the doctor vs. the patient and the nurse?

Family Analogy

I believe the latter is more likely the case.  I received some interesting insight from my coworker who is a practicing physician on the subject matter.  He described medicine using a “Family Analogy.”  If medicine is viewed like a family, the doctor is the stern, paternalistic father who is the ultimate decision maker.  The nurse is not necessarily the mother, but more of the older sister.  This is not at all intended to downplay her decision making authority, but rather because of the intimate relationship that can develop between patient and nurse.  The nurse, just like a sister, will know everything about you, while a mother may usually doesn’t.  Hence often there is a certain aversion to the fathers decision making, because of a feeling of lack of true understanding.

Understanding!

The key is understanding.  Sure, it’s obvious one must have an academic understanding of the disease/symptoms/patients, but what about sympathy/empathy?  Empathy is DEFINED as a deep emotional understanding!  Doctors need to break down the traditional view of doctors as the father, and become a knowledgeable friend.  You can confide within a friend, and there is a level of trust inherent in the relationship.  And because he/she is knowledgable of the subject matter, in this case medicine, you can be certain they are making informed decisions.  No longer should a doctor be the single decision maker, but become a consultant, and informed friend, that assists your decision making.

Conclusion

Now I need to make it abundantly clear, and reiterate ad nauseam,  that I am going to be a doctor (in about a decade), so I have no incentive to downplay my future professional importance.  Rather, I am writing this as a call to arms to future doctors to change the current ways.  Likeability, empathy and trust are as equally important as competence.  Haven’t you ever seen or heard of the show House?  90% of the drama is a direct result of his obstinate and excessively rude behavior.  He is a incredibly brilliant robot, with no humane bone in his body.  (I hate “cite” a fictional TV character, but he personaifies the negative extreme I’m trying to convey.)

So doctors, if you don’t want to be replaced by the medical computing robot of the future, you need to become a “person” again.  Technology will continue to encroach into every aspect of our lives, and it will become more intertwined with our daily living.  However one thing has and will also be a fundamental constant with humanity–our affinity to real people.  We are behaviorally hardwired towards other people, and millions of years of evolution will not disappear so quickly.  We are especially in need of human interaction when we are sick, further highlighting its importance in the hospital setting. So yeah, a computer could, and most likely will, become a better diagnoser in the future.  But the best doctors will always be those who truly understand people, and are able to heal the physical and emotional side of the patient.

Bring it on you super computers…despite your obvious advantageous, I know my skills will always be needed.  My profession isn’t going anywhere soon.  (We still have accountants, don’t we?)