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GBE's avatar

I was trained by my mentors to sit with and to observe my laboring patients. After some time, I could often accurately estimate the dilation of the cervix without doing a pelvic exam. I could also recognize whether a labor was progressing normally, or whether exhaustion was setting in and some assistance was required. I encouraged my patients to move around and to assume differing positions which were more comfortable. If I left the room, all the nurses, attendings, and residents were at the central station, staring at computers. The fetal monitor tracings of their patients who were paralyzed with epidural blocks were visible on a monitor. The result was that my patients had shorter labors, a very low rate of need for pain medication, and most went home the next day. My Cesarean section rate was 6%. My hospital's overall Cesarean section rate was 35%. None of the other doctors were curious enough to ask why my C-sect rate was so low.

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Conway Judge's avatar

Very interesting read.

I am not surprised to hear this obsession with algorithms in healthcare exists. I mean who doesn't like algorithms. I like algorithms. Make them, use them, develop them for a host of reasons.

In emergency medicine it makes perfects sense to have them. But algorithms for working with more complex issues? Hmmm I very much doubt they could ever replace free thought. We are not smart enough. Thus neither are the things we program.

As much as I love algorithms, trends and patterns. I equally love outliers.

I love outliers because, well there has to be a reason those things do not conform with the trends most other things do. And the most plausible reason why they don't fit within the observable trend is because our model.. the way we map the trend is wrong.

I think we think we know a lot. But are in a matter of fact arrogant and have much yet to learn.

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