The notion began early in computer science class during Jason’s freshman year. The professor had noticed a certain elegance and zeal in his work and suggested medicine. That was in the days of the giants when clinicians were tied to such clunky programs as meaningful use and PQRS. In this antiquated milieu, Jason cut his teeth on basic health care architecture.

In those prehistoric years, there still remained a bias toward eye contact and empathic expression. Thankfully, over time, the technocrats pushed the boundaries. Jason couldn’t be happier. His hands hovered over the keyboard, and his eyes took in each field with accuracy. Diagnostic algorithms, demographic screens, drug to drug interactions. By the end of the first year of medical school, he mastered every simulation.

Years two and three couldn’t have been easier. The newly approved glass separators made clinical encounters almost identical to the simulations. Jason was a pro from day one. He rarely felt the need to look up from the monitor.

By residency, Jason had mastered the new duplex screen modalities. Instant messaging allowed for multiple simultaneous visits. Each patient’s biometrics were scanned during registration and appeared on the client visualization window.

The truth was, Jason ignored the biometrics. He hated to connect a face to the data. He avoided names also. Too personal. Too close. He preferred raw data. Each numeric morsel placed in exactly the right box, on the right screen, in the right folder. Clean as can be; no mess.

Jason spent the next decade honing his skills in practice. He rose to the top quickly. His data was entered faster, more cleanly, and with fewer errors than his peers. Such accuracy was profitable. He qualified for almost every governmental bonus, and his year-end stipend was among the highest.

Change came subtly at first. Jason felt mild anxiety when the glass separators were removed. Then there was the thing about shaking hands. A new quality indicator, a governmental bigwig had suddenly decided that human touch was somehow related to well-being.

A few years passed before the new physical exam mandate was rolled out. Some yahoo decided that stethoscopes were required for each exam. Jason figured that a crooked politician had a friend who sold the old time relics and needed a new revenue stream.

The changes began coming faster. First, the state-sponsored communication classes. Then the new gowns and privacy policies. The yearly clinical exam.

Each mandate cleaved at Jason’s soul. He was a master, and his mastery was slowly being eroded by nontechnical politicians who barely understood the beauty nor complexity of a clean data input screen. He was slipping. He almost submitted an incomplete claim the other day because he was futzing around with a defective sphygmomanometer.

The data was suffering. The consequences were momentous. Doctors were working untoward hours to feed a ravenous monster that was no longer connected to any real version of health care.

And Jason was on the Internet every spare hour, looking for a posh consulting job.

Jordan Grumet is an internal medicine physician who blogs at In My Humble Opinion. Watch his talk at dotMED 2013, Caring 2.0: Social Media and the Rise Of The Empathic Physician. He is the author of I Am Your Doctor: and This Is My Humble Opinion.

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