As a result of my posting “Earthlings and Htraesians: The Parallel Worlds of Medicine and Healthcare IT“, a discussion has started on the HISTalk blog. That discussion thread can be seen in the comments section here.
This posting from a PhD raised my eyebrows (emphases mine):
I have seen many people get hired into IT with degrees in everything from Zoology (really) to other non related fields. Their degree offers no value to the position or the job at hand. I think a physician is no more qualified to run IT than a CIO is qualified to perform brain surgery. I believe in a good mix of clinicians and technical experts makes the best combination on implementation teams. However, running an IT department is completely different than running a medical practice. Physicians who believe they can lead IT in healthcare are as misguided as CIOs who think they can design the perfect EMR. PS - I am a PhD in Information Science and do not presume to cross the line into medical practice.
“Physicians who believe they can lead IT in healthcare are as misguided as CIOs who think they can design the perfect EMR?”
That non-physicians cannot practice medicine (i.e., “CIO’s not qualified to perform brain surgery”) is axiomatic and irrelevant to the argument. However, to say a physician cannot practice something outside of medicine is a non sequitur (at best).
Has the writer spoken to each and every physician, once-physician, retired physician, physician informaticist, physician MBA, and every other physician on the planet, I ask part tongue in cheek and part dead seriously?
The CIO with medical credentials is as rare as hen’s teeth, but as I have pointed out in the past, this is not a symmetrical affair. This is especially true in the culture of medicine, where when the opportunity arises, physicians seek additional education (e.g., in healthcare informatics).
What has led to such stereotypical thinking in our society where physicians are concerned? I find the phenomenon alarming, for I encounter it at least as frequently (if not more) than I did when I wrote this piece - a decade ago! - on stereotypes about physicians and IT.
Importantly, I believe this and related stereotypes about physicians are a driver and an enabler (either through genuine belief or through disingenuous opportunism) of much that ails medicine today through the interference of non-medical outsiders. The fundamental message is that physicians are children who cannot do anything more than medicine, and require “a village” of paternalistic non-medical outsiders to manage their affairs.
My response was as follows. I decided to offer specifics, although it is hard to reason people out of a position they arrived at irrationally:
It appears you just stereotyped physicians, who often have significant predoctoral and other experiences beyond medicine, especially those who’ve pursued graduate and postdoctoral training in informatics.
It it in part through such stereotyping, resulting in the exclusion or marginalization of needed cross-disciplinary domain expertise, that health IT runs into expensive, unnecessary difficulty, or fails.
However, you have not stereotyped CIO’s regarding inability to perform neurosurgery, unless that CIO has an MD and training and boards in neurosurgery.
I am a physician, practiced internal and occupational medicine, so I would appear to fall under your statement. My minor in college was computing, right up to IBM 370 assembler, and I began computing years before college via unfettered access to a DEC PDP-8 and via a Heathkit H-8 I built in medical school for clinical-related experiments, 1978. Also built an infrared-sensing heart monitor in my elective in biomedical engineering at BU School of Medicine.
That background is not entirely atypical for those in medicine who are interested in IT.
Please evaluate my other background items in my online bio, for example, and then tell me why doctors are “unqualified to run IT.” As an information scientist, it should be easy for you to locate that bio.
I await a response.
– SS
Addendum - I received this response (the person’s email address field indicating they are a fellow of HIMSS, the organization that certifies people as “Professionals in Healthcare Information and Management Systems” after a 100-question multiple choice exam):
Understand your comments. I meant to imply, but failed to say, physicians without IT training or CIOs without medical training.Sorry for the confusion.
Here is a provocative question: was that a genuine clarification, or one done under duress of being challenged? (I believe my points — in all of my writings including the ones that led to the HISTalk thread — about the type of physicians best for HIT leadership roles have been extremely clear.)
I will, of course, assume the former as the motivation for the clarification. I replied,
You might add that in a follow up comment.
The problem has become one of stereotypes that are then used (either through genuine belief or disingenuous opportunism) for purposes that serve no one, including patients!
And in fact, the clarification was indeed soon added as a follow up comment by the poster.
– SS