Geared Up For Health

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The people most nostalgic for old-time medicine may turn out to be M.D.s, not patients. "What happens if you're able to provide a checkup a day from your kitchen, you are able to access your data at the local drugstore, you are able to guide your own health and purchasing decisions?" asks Coughlin. "Suddenly you or, typically in this country, your adult daughter becomes the real linchpin to care, and your doctor — who has been trained to provide services on site, in person, essentially God with tenure — turns into a systems consultant or systems administrator."

Of course, one factor we risk losing track of in all this is the healing power of the doctor as a human being willing to tune in to you. Dr. Colin Phoon, a pediatric cardiologist at the New York University School of Medicine, writes in a provocative essay titled "Must Doctors Still Examine Patients?" that being examined "has a calming effect on anxious patients, [and] a placebo effect on somatic but nonorganic complaints." Touch, we seem at risk of forgetting, is a basic part of the healing process, a fundamental expression of caring. Yes, an echocardiogram is technically better than a stethoscope for examining the heart, and an automatic blood-pressure cuff can take as good a reading as a nurse. But you don't need a Ph.D. or a degree in psychology to realize we would all lose something very important if we cut human beings out of the healing loop.

And that brings us back to Dishman at Intel, who doesn't necessarily favor a fully automated health-care system devoid of the doctor-patient bond. He's not a technocrat by training or by nature. He's a sociologist who studies people — their needs and desires. "People didn't really embrace hearing aids until they became small enough not to be embarrassing," he says. That's even more the case with something as sensitive as incontinence — a problem, like so many, that technology can help solve, but only once we're willing to accept the cure.