Technology and the Changing Nature of Health Care
In addition to making certain tests and treatments almost unavoidable, new tech- nologies have dramatically changed the very nature of health care for both health care providers and consumers.
Just a few decades ago, health care was an intensely “hands-on” experience. The doctor would literally lay his (or, rarely, her) hands on the patient, feeling the belly to check for swelling or lumps, thumping the chest to listen for abnormal lung sounds, and so on. A thorough physical examination could take up to an hour of intense questioning and physical probing. As this suggests, medical care also relied heavily on listening to the patient’s report of his or her symptoms and concerns. Surgery, too, was bloody, intimate, hands-on work.
These days, doctors give far less attention to patients’ reports of their health and far more attention to results from medical tests. Those tests, meanwhile, are largely performed not by doctors, but by technicians who collect and analyze blood samples, ultrasound readings, CT scans, and other tests. Meanwhile, an increasing proportion of doctors work primarily within the body as surgeons, spending little time interacting with patients. Moreover, surgeons now often use computers to manipulate microscopic surgical tools, further distancing their own bodies from their patients’ bodies.
As this suggests, technology also has led to the rise of a wide range of new health care occupations, shifting many tasks from doctors to these new provid- ers and threatening the balance of power within health care (a topic discussed more fully in the next chapter). At the same time, new technologies (coupled with changes in the structure of insurance and hospital care) increasingly have shifted care onto patients and their families and away from health care providers altogether. As the earlier discussion of family caregiving suggested, many families now have both the opportunity and often the financial need to provide high- technology care in the home—from injecting insulin in children with diabetes to operating ventilator machines for those who can’t breathe on their own.