My endocrinologist recently ordered blood work for me. "Here," she said, handing me a computer-generated form with my name, insurance information, and testing particulars on it. "Schedule your appointment online. Then take this to the diagnostic center upstairs to get your blood work done.”
I scheduled my appointment, and the following day, my husband Bill and I arrived at the center. Instead of a friendly receptionist greeting us, two 'kiosk' machines were stationed in front of what was once the receptionist's window.
I stepped up to one kiosk (Bill nicknamed it ‘Quentin.’) and scanned the QR code on my orders. Quentin prompted me to step on the digital scale at the bottom of the kiosk. Afterward, Quentin instructed me to put my driver's license and insurance card under a scanner that quickly read the information. Within minutes, I was efficiently registered. Despite our appointment, we waited for two hours in an overcrowded, stuffy waiting room with limited seating until we were summoned behind a closed and locked door. I was poked and prodded until a plump vein was found. Eventually, four vials of blood were taken.
Before leaving, the phlebotomist handed me an orange jug saying, “Collect your urine in this for 24 hours. Store your urine jug in your refrigerator between collections. Follow the instructions on the side of the jug and bring it back the next day. Remember, always keep it cold."
For 24 hours I collected urine. Afterward, I labeled and sealed the jug according to her instructions, keeping it refrigerated until we could return it the following day. The next day we checked in with Quentin, who quickly alerted a nameless lab technician who emerged from behind the closed and locked door.
Without making eye contact, he retrieved my orange jug.
“What happens next?” I asked.
He offered this canned explanation: “A technician will test your urine to determine if you’re retaining or flushing out your calcium. Your endocrinologist will receive the results by the end of the week. She’ll use the information to determine what’s causing the demineralization of your bones and your osteoporosis.”
Without saying another word, he turned and walked away. On the way out, I glanced over at Quentin, resisting the urge to say goodbye. As I boarded the elevator, I couldn’t help but wonder what happened to the ‘care’ in healthcare. Why the minimal human contact, limited interaction, and overall dehumanization I experienced? Economics? Efficiency? Maybe people just don’t want to interact anymore? Maybe they don’t know how to, don’t want to, or are afraid to do so. Maybe they’re protecting themselves against "burnout" from the emotional demands of working with suffering patients.
Nonetheless, Quentin and similar health information technologies are used with increasing regularity to automate many aspects of medical practice. True, new technologies are wonderful tools. Humans have been using tools throughout time, but I wonder, are these new tools adding to or detracting from humanity?
From my perspective, they minimize our humanness, sacrificing care for efficiency.