Rating: 7.0/10.
The Doctor Who Wasn’t There: Technology, History, and the Limits of Telehealth by Jeremy A. Greene
This book examines the roles of various technologies in healthcare, primarily through historical and social lenses, covering issues such as how different technologies changed how doctors and patients viewed healthcare and the power dynamics between doctors, patients, and technology providers. The writing style is quite academic and mostly studies how various people historically viewed these advances in technology and how they were reported by the media; there is not much details about medicine or technology, the emphasis is on social phenomena, and I got bored after reading about half of it.
One of the first technologies introduced to healthcare was the telephone, which gave patients the ability to call their doctor instead of seeing them in person. However, this innovation introduced issues of liability and burnout as patients expected to be able to call their doctor at any time, while doctors might be occupied with other tasks and unable to answer the phone promptly. Communication over the phone required different procedures and was prone to miscommunications when the severity of conditions was not properly conveyed, requiring patients to describe their symptoms in a specific way that was efficient for telephone interactions.
The development of wearable devices that monitor physiological signals and transmit them by radio began with the Holter ECG, which required users to carry a briefcase nearby. Advances in technologies have made these monitors a lot smaller, such as pills that can be swallowed. There are concerns about the invasion of privacy, like when these devices are used to monitor the workplace. Another issue is that the devices can generate an overwhelming amount of data that is challenging to process.
The pager was a device to contact physicians from anywhere and initially promised greater autonomy, as physicians could now go wherever they wanted while remaining available at any time. Some hospitals invested in wiring so that their physicians could be paged from anywhere in the hospital, but eventually many grew to resent being available at all times being on-call for all hours and pushed for being able to turn their pagers off to have some privacy.
Telemedicine began as a way of connecting patients and doctors through television so that doctors could see patients and better diagnose them compared to voice-only interactions. There were concerns about privacy and whether wireless signals could be intercepted, as well as concerns that doctor-patient interactions would be reduced when physical presence was lost. In the 1960s, studies were conducted about the color of backgrounds and the position of TV screens, though these studies ignored the issues of social power differentials that would be amplified by this type of technology.
