Doctor Barbie has a laptop. She comes with other accessories, like a white lab coat and stethoscope of course, but one of her largest and most prominent medical tools is her laptop. As a pediatrician’s daughter, my child selected doctor Barbie from the aisle of infinite Barbie options because she knew I was most likely to purchase this one when otherwise walking the store repeating the mantra “no more toys.” So Doctor Barbie and her laptop now live with us and my daughter plays doctor, not by examining patients but by having her type on the keyboard.
“Do you use a computer like this one, mama?” she asked during one of the baby Barbie’s check-ups. I do not remember a Doctor Barbie in the 1980’s when I played with these silicone women, but I would imagine that her accessories included a reflex hammer and maybe even a microscope. My reflex hammer, purchased in medical school and balanced precariously in my white coat pockets for select months of my training, now sits idly in my home office. Alas, I conceded to my daughter that yes, mama spends a significant portion of her day typing on a computer, just like Doctor Barbie.
When I entered medical school I underestimated how much computer time would be in my future. I knew I would need it for documentation and to look things up on the great all-knowing Internet, but I could not imagine that computers would become fixtures in every exam room, touchdown space, and office that I would enter throughout my routine day. There are no longer verbal orders for medications or procedures; if it is not in the computer system, it does not exist.
One of the struggles many doctors face is how not to let the computer become a wall between us and the patient. How can I type while the patient is talking to maximize capturing the accuracy of what they are saying in my documentation and my workflow efficiency without becoming impersonal? There are some conversations that start innocuous and slowly as they move toward ultra-sensitive or highly emotional, the pace of my fingers on the keys slows to an eventual halt. The click-clack of typing does not engender a patient’s trust in divulging intimate details of their life. At some point though, it must be documented and so I retire to my work-space to type up the encounter, which is the only way others will appreciate and value it.
In addition to being my medical chart, my computer is now my laboratory, image library, pharmacy, textbook, immunization schedule, and growth chart. System outages can create a temporary pandemonium so disorienting that years later I can still remember the exact date of each episode. I remember in one such event walking around with a three-inch thick dusty medical textbook photocopying blood pressure charts for different ages and genders when my younger office staff said, “Oh Dr. Lockwood is so retro.”
Having computers in my career has certainly brought with it many advantages, particularly improved knowledge sharing between physicians and between physicians and patients. I am thankful each day for a good computer and typing teacher in Middle School, who is likely just as important as any medical school professor. The computer allows certain safety protections, reminders, and guidelines that allow for better patient care. I no longer need to decipher the scribbles of other physicians when everything is neatly before me in Times New Roman.
The makers of Doctor Barbie got me right, at least in accessories if not in body proportions. Watching Doctor Barbie type through her check-ups makes me cringe because of how close to the truth it is. She may not be the doctor I imagined growing up, but is certainly the modern doctor I have become. I am grateful to Doctor Barbie though because she reminds me to be mindful not to let the advantages of technology push out the traditions that made me fall in love with medicine.
[The opinions expressed above are my own and do not necessarily reflect those of my employer, Children’s Hospital of Philadelphia.]