In Tech, Medicine Does Not Trust
While there’s a lot of practical reasons why stakeholders in medicine don’t trust technology firms; many of the reasons are cultural and stem from a lack of common experiences and alignment towards expectations.
I’m stunned daily by the cultural gulfs between medicine and tech in my role as CEO and Board member at Medigram, a mobile technology company serving medicine. To help bridge the gap and build trust, the Medigram team is honored and grateful for the opportunity to collaborate with a number of editors, publishers, and subject matter experts in our related domains for a number of publications. Without trust, the medical communities do not adopt products. As pictured below, publications are part of what one tech advisor that “gets it” calls, the historical “trust chain” for adopting products in medicine. We really appreciate the mentorship and teamwork; each project is highly manageable and doesn’t interfere with company building time since the writing and editing is mostly addressed during the weekends. It’s obvious to stakeholders with experience working in medical environments, why it’s necessary for a company like ours to “publish or perish” in a medical context. However, underscoring the cultural rift between tech and medicine, several friends with tech backgrounds (I grew up in Silicon Valley) have responded with quizzical looks when our publishing activities are mentioned. Some collaborators with tech backgrounds have gone so far as to challenge publishing as a waste of time. In this post, we demystify how physicians learn and we look to scratch the surface for what the learning standards are in medicine. This would be a topic foreign to many technologists, along the same lines as perhaps privacy and security, for examples. Notice in the graphic below in the second orange box (traditional step 2) that journal publications are a mainstay of physician knowledge generation and learning.
To set the stage, let’s review a few contextual points:
- There’s a huge controversy right now over patient privacy and technology, this issue is very important in terms of explaining lack of trust of tech in the medical community. Though because privacy is such a complex topic and multi disciplinary to medicine, law and technology, we’re holding off on providing the potential explanation of impacts of privacy to trust for an upcoming textbook in development together with colleagues and collaborators including physicians. [1]
- Behind closed doors, a surprising number of leading and influential physicians disrespect and appear to become visibly annoyed when a tech company appears that they’re “using” a physician’s reputation or credibility inappropriately.
- In order for physicians to maintain their license to practice medicine, they must undergo mandatory, continuous training. This standard doesn’t exist in tech; though it should in my view for tech that’s used in medicine. As an aside, at Medigram we believe that tomorrow’s health tech winners will impose the physician continuing education standard and more on their workforces. This is in service of much needed efforts to bridge enormous gaps of understanding between the domains. For physicians in California, this mandatory, continued professional training is 25 hours a year; it is called continuing medical education or CME. [2] CME consists of educational activities that serve to maintain, develop, or increase the knowledge, skills, and professional performance and relationships that a physician uses to provide services for patients, the public, or the profession. Any CME learning activity has to be accredited by the Accreditation Council for Continuing Medical Education to sponsor CME programs for physicians. Events must comply with the ACCME’s policies and those of the accredited training site. [3]
4. Physicians appear to overestimate their individual skills and abilities as a whole, less frequently than developers and programmers in tech seem to [4]; another big cultural gap. Notice the inclusion of professional relationships as a stated goal of CME.[3] This is because much of medical practice happens in a team context. Unlike less skilled and inexperienced technologists and developers that don’t work well in teams, physicians are less likely to overestimate their abilities; those physicians that perform better and are respected in their field largely tend to make a practice of deferring to colleagues with greater specialized knowledge when developing treatment plans and decisions. This is largely due to managing professional liability and the fact that lives are at stake.
5. Much lack of trust in the medical community stems from current technology in use in the medical environment. Any newer vendors have to therefore earn the trust of physicians and other stakeholders. [5] Our team at Medigram is willing to do the hard work to do just that.
By: Sherri Douville CEO & Board Member at Medigram, Inc. https://www.linkedin.com/in/sdouville/
[1] “Lawmakers call for HIPAA updates following Google’s data deal” https://www.politico.com/news/2019/11/15/lawmakers-call-for-hipaa-updates-following-googles-data-deal-071088
[2] “Continuing Medical Education: CME State Requirements” https://www.boardvitals.com/blog/cme-requirements-by-state/
[3] “Plan a CME event” https://www.advocatehealth.com/education/continuing-medical-education/plan-a-cme-event/
[4] Can I become a doctor just by learning from the Internet, like software engineers? https://www.quora.com/Can-I-become-a-doctor-just-by-learning-from-the-Internet-like-software-engineers/answer/Sherri-Douville?ch=10&share=7699dae2&srid=2Iyj
[5] “Death By 1,000 Clicks: Where Electronic Health Records Went Wrong” https://khn.org/news/death-by-a-thousand-clicks/
