Limits of Technology - An Apology to a Surgeon

In a recent Sermo post “Wild, Crazy, and Creative Doctors” I carried on how important innovations are to every field of medicine. I cited several IT innovations that saved time. A surgeon protested. He said, in the main, IT innovations had never saved him time or helped him become more productive.

I flippantly commented he was wrong. I apologize. I was wrong, and he was right. Most IT innovations - EMRs, email, computer history taking – are designed to help primary care doctors, not surgeons. There may a few Internet innovations out there to help surgeons – online programs helping prepare patients for surgery, patient education videos, and doctor-controlled coding programs – but not many.

I should have also said effects of innovations are uneven. They cut both ways. Surgeons have always been extremely innovative in developing surgical devices, and laporascopic and bariatric surgery have been advances. But in other ways, innovations have shrunk the general surgeon’s world. Proton inhibitors and antibiotics for helicobacter organisms have helped make gastrectomies almost obsolete; surgeons at trauma centers have replaced many independent general surgeons; CTs and MRIs have lessened the need for exploratory laporatomies; stents and endovascular devices have minimized endovascular surgical procedures; endoscopies have reduced the number of surgical explorations; interventional radiologists are now performing deep biopsies; and there’s a general and inevitable movement towards non-interventional approaches to disease.

Innovations have profoundly effected general surgery. I apologize for over-generalizing about the uniformly positive effects of innovation on every specialty.



In a recent Sermo post “Wild, Crazy, and Creative Doctors” I carried on how important innovations are to every field of medicine. I cited several IT innovations that saved time. A surgeon protested. He said, in the main, IT innovations had never saved him time or helped him become more productive.

I flippantly commented he was wrong. I apologize. I was wrong, and he was right. Most IT innovations - EMRs, email, computer history taking – are designed to help primary care doctors, not surgeons. There may a few Internet innovations out there to help surgeons – online programs helping prepare patients for surgery, patient education videos, and doctor-controlled coding programs – but not many.

I should have also said effects of innovations are uneven. They cut both ways. Surgeons have always been extremely innovative in developing surgical devices, and laporascopic and bariatric surgery have been advances. But in other ways, innovations have shrunk the general surgeon’s world. Proton inhibitors and antibiotics for helicobacter organisms have helped make gastrectomies almost obsolete; surgeons at trauma centers have replaced many independent general surgeons; CTs and MRIs have lessened the need for exploratory laporatomies; stents and endovascular devices have minimized endovascular surgical procedures; endoscopies have reduced the number of surgical explorations; interventional radiologists are now performing deep biopsies; and there’s a general and inevitable movement towards non-interventional approaches to disease.

Innovations have profoundly effected general surgery. I apologize for over-generalizing about the uniformly positive effects of innovation on every specialty.