Do Computers Erode Doctor and Patient trust?

Doctor and Patient Trust is a difficult thing to quantify. The bond between a medical professional and the people they serve takes time to grow.

I remember when I was 7 years old; my family doctor would invite me and my mother into his office, and would sit in his well-worn examination chair. My mother would sit next to me, as the doctor listened carefully, patiently to my complaints.

Thankfully I had a healthy childhood and my doctor visits were usually for health checkups or the occasional cold, but what I remember most from this period is the caring attention of the doctor. He would look at me, wait for me to finish speaking, and then consider what might be a suitable course of action based upon his experience.

What this interaction did for me was to build my trust in doctors. The face-to-face attention was the key factor in feeling listened to and cared for.

Fast forward to my last doctor visit about a year ago, at age 37.

I was new to the area, and so had to search for a doctor that accepted my insurance. I chose a friendly looking doctor from the list and made an appointment. Two days later, I was ushered into a private room by an assistant, where I was given some forms to complete. After about 15 minutes, the doctor appeared at the door with a laptop in her hands. Instead of looking at me, she was looking at the screen as she walked, and simply asked my name.

For the next 10 minutes, as I divulged my ailments and concerns, she mostly typed away at a laptop on the other side of the room, occasionally nodding along to what I was saying.

I can’t say she was rude, or dismissive, in fact she was exceedingly polite. Yet there was somehow, something missing.

After I left with a prescription, I tried to pin-point what felt so different about this experience. The doctor and patient trust just wasn’t there for some reason.

I finally realized what it was: the doctor wasn’t connected to me, but to the computer. I was essentially just a data entry source, like someone taking an impersonal survey.

The trust that I had felt for doctors most of my life started to feel somehow eroded, as I wondered whether I would return here again.

Most of us have probably noticed a similar change in doctors’ behavior during the past 15 years. It is not something that has affected doctors alone, as it seems that most of the world is now staring at screens rather than looking at each other.

A recent JAMA study attests to this fact. According to Dr. Neda Ratanawongsa, who co-authored the research letter ‘patients sense that their clinicians aren’t listening as carefully to them’. The fact is that Doctor and Patient Trust is eroding as technology becomes more and more a part of the medical experience.

The study found that only 48% of the patients of physicians with heavy computer use during clinical encounters rated the care they received as ‘excellent’ on patient experience surveys, whereas the 83% of patients whose physicians were less engaged with their computers during the encounter felt the care they received was ‘excellent’.

Another study undertaken by Technology Advice on Patient Engagement found that the use of technology in medicine is welcomed in a lot of areas. 60 percent of patients reporting that digital services were “important” or “somewhat important” in their choice of provider, especially when it comes to finding a doctor, paying and researching medical conditions.

However, this changes once the patient is face to face with the doctor.

According to Dr Richard Frankel, “When people are paying attention to the same thing at the same time, you get the best transmission of information. Technology in the exam room is neither good nor bad inherently, but doctors can use specific techniques to help patients get comfortable with it.”

As the dependence of technology grows in society, we all know it can become increasingly difficult to wrestle ourselves away from it. Doctors have incredible pressure to provide accurate reporting and a thorough diagnosis, and yet somehow at the same time gain the trust of patients.

Perhaps part of the solution comes from my childhood doctor. Before going to the reporting or diagnosis phase with a patient, doctors can simply spend a minute or two face-to-face with a patient, listening and building trust. Those few precious minutes will reap benefits, and build both doctor and patient trust and satisfaction.