Alan Stolier, MD/


gladwell1Marking the publication of his latest tome, Talking to Strangers, Malcolm Gladwell sat down for an interview for Web MD magazine with Lauren Paige Kennedy. Gladwell spoke about the difficulty in assessing strangers and how this impacts doctors and patients, and how technology may enhance these interactions. The overriding premise of the book is that we “extrapolate from people with whom we are intimate, with people with whom we are not. And that can get us into trouble.”

He was asked whether this concept applied to medicine. He noted that “the current economic model of medicine results in giving physicians less and less time with patients who may require complicated medical decisions. Moreover, we are in most instances, dealing with strangers and have minimal time to make these decisions. Gladwell notes that doctors are complaining about spending less and less time with their patients. Gladwell says “that one conclusion that you can take from my book is that they are 100% right to make that complaint. You cannot expect a doctor to make sense of a stranger in 10 minutes.”


Kennedy noted that according to a study published in the Annals of Internal Medicine in 2016, physicians spent just 27% of their total time in actual face-to-face with patients. They spent an incredible 49.2% of their time on the electronic medical record! David Agus (photo on right), professor of engineering and medicine at the USC Keck School of Medicine agrees. He notes that “Doctors spend the majority of their time entering data while staring at a computer. A doctor needs to look at how patients are holding their body, how they're breathing. It's hard to do that when there’s a computer monitor between the doctor and patient.”

Gladwell isn’t against innovative technologies. He reminds us, however, that there's more to health care than a diagnosis. He says, “that an overwhelming reason that we go to doctors is reassurance and consolation. We go to have our illnesses treated, yes, but we need to have more respect for the human role of the doctor...” Furthermore, he says “that we need to decide where the machine does best and the human does best - perfecting both sides of the equation.”


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