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The Hypocrite's Oath: Has modern medicine compromised the Hippocratic Oath?

“I will respect the hard-won scientific gains of those physicians in whose steps I walk, and gladly share such knowledge as is mine with those who are to follow.”

“I will apply, for the benefit of the sick, all measures [that] are required, avoiding those twin traps of overtreatment and therapeutic nihilism.”

“I will not be ashamed to say "I know not," nor will I fail to call in my colleagues when the skills of another are needed for a patient's recovery.”

Doctors begin their careers with The Hippocratic Oath, swearing to uphold moral and ethical standards for the wellbeing of the patient. But the attitude among many doctors has evolved into a modern day version along the lines of "I'll do what I can for the patient, unless it puts myself in jeopardy." There is an ideological shift happening in medicine, and it is keeping doctors from providing the most complete care possible.

Doctors are becoming victims of a litigious society that is changing the way they communicate about patient care. Even though there has been a rise of advanced, secure communication platforms in health care technology, there is an emerging phobia of all information becoming discoverable. Doctors are having to censor their communication lest it resurface in a malpractice lawsuit.

I was recently working with a doctor during a mobile charge capture training for pMD, and he echoed an all too familiar mantra in the industry. He generally doesn’t record anything that he wouldn’t want the world to see. At some point in his career, he had taken a strong stance of never recording any information in his EHR around patient care that could potentially be used against him, even if sharing that information meant helping the patient. Yet the alternative, sending sensitive information in non-secure texts or writing it on pieces of paper or not sharing it at all, is far worse. This reaction points to the hesitation that exists in the health care community to record any kind of informal, candid information about patient care, stemming from a larger “Big Brother” paranoia. So what are doctors not saying that could be jeopardizing patients (and breaking the Hippocratic Oath)?

Advanced communication platforms for sharing health care information are being developed to improve care coordination among providers, allowing them to stay involved in up-to-date patient information more fluidly. The unintended consequence is that providers are becoming more cautious about sharing certain medical information and fostering trust issues with the system at large. Communication is imperative in medicine, and it’s an uphill battle against many different forces to improve and increase the communication in the patient + doctor + administrator intersection.

Doctors pledge that they will apply all measures necessary to care for their patients and gladly share knowledge with each other. It's time that "Big Brother" backs off so doctors can start using technology as it’s intended - as a resource used to save patients rather than avoiding it to save themselves.
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