Electrocardiography: The Need to Modernize
Many physicians say that certain time-tested methods used to examine patients are no longer needed. Some imply, by their actions, that a patient's history yields little information, while others indicate that the physical examination of the heart is no longer needed -- naively believing that the skill of auscultation has been totally replaced by echocardiography. Others say that electrocardiography is no longer needed because more modern technology has replaced it. This view, I believe, is a bit radical, and I note that those who make such pronouncements still go through the motion of using a stethoscope and continue to inspect electrocardiograms -- although their ability to perform these tasks is often limited.
Obviously, medicine will continue to change. When better and cheaper technology is developed, we should lay the old methods aside. However, there is a greater likelihood that more modern technology will replace existing "high" technology rather than time-tested "low" technology (such as the history, physical examination, electrocardiography, and chest radiography). For example, magnetic resonance imaging with contrast media may, in the years ahead, replace coronary arteriography.
In my wildest and most ridiculous dream, I envision a distant world where there are very few doctors. Those that exist produce software for computers. Personally owned machines of various sorts --including ones capable of making diagnoses and prescribing treatment, even the use of robotic surgery -- could replace physicians in such a high-tech world. So, yes, electrocardiography may not be used at some point in the distant future. But for now, and for the foreseeable future, electrocardiography is indispensable. Until it is clearly displaced by better and cheaper technology, we should extract as much useful information from the electrocardiogram as possible.
We also must realize that modern research has changed the field of electrocardiography and that computers have failed to keep up. Arguably, the computer read-out of electrocardiograms is the most outdated information in US hospitals.
Many physicians say that certain time-tested methods used to examine patients are no longer needed. Some imply, by their actions, that a patient's history yields little information, while others indicate that the physical examination of the heart is no longer needed -- naively believing that the skill of auscultation has been totally replaced by echocardiography. Others say that electrocardiography is no longer needed because more modern technology has replaced it. This view, I believe, is a bit radical, and I note that those who make such pronouncements still go through the motion of using a stethoscope and continue to inspect electrocardiograms -- although their ability to perform these tasks is often limited.
Obviously, medicine will continue to change. When better and cheaper technology is developed, we should lay the old methods aside. However, there is a greater likelihood that more modern technology will replace existing "high" technology rather than time-tested "low" technology (such as the history, physical examination, electrocardiography, and chest radiography). For example, magnetic resonance imaging with contrast media may, in the years ahead, replace coronary arteriography.
In my wildest and most ridiculous dream, I envision a distant world where there are very few doctors. Those that exist produce software for computers. Personally owned machines of various sorts --including ones capable of making diagnoses and prescribing treatment, even the use of robotic surgery -- could replace physicians in such a high-tech world. So, yes, electrocardiography may not be used at some point in the distant future. But for now, and for the foreseeable future, electrocardiography is indispensable. Until it is clearly displaced by better and cheaper technology, we should extract as much useful information from the electrocardiogram as possible.
We also must realize that modern research has changed the field of electrocardiography and that computers have failed to keep up. Arguably, the computer read-out of electrocardiograms is the most outdated information in US hospitals.
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