The “Fine Art” of Medicine

Patients may have internal concerns about the encounter being recorded, particularly with respect to machine language output, privacy of information, and accuracy of the report, which may be mixed with a loss of personal connection with the otolaryngologist. Understanding these potential concerns can proactively lead to a discussion with the patient regarding the otolaryngologist’s ultimate responsibility to review, revise, and improve the scribed report.

The same technology that risks eroding compassion, empathy, and understanding, however, can also support them if deliberately guided by otolaryngologists who understand the importance of relationship-centered care. If virtual scribed reports improve efficiency without diminishing the accuracy of the encounter, and if the otolaryngologist’s time availability for patients is increased, then the effect can be positive. The main concern is that additional patients will be inserted into the daily schedule, missing the vital opportunity to spend more time with each patient in their encounter, which could improve communication and strengthen the patient–physician relationship.

In this scenario, the otolaryngologist (aka Dr. Jones) has missed several opportunities to better understand and explore the impact of the disease on both Reverend and Mrs. Smith and to provide important empathy and understanding to them. As an early-career otolaryngologist, Dr. Jones is still acquiring the clinical skills to provide excellent evidence-based care within the overarching context of humanism. Dr. Jones’ undergraduate and graduate medical education heavily emphasized evidence-based practice and a growing reliance on AI-supported clinical care. Unfortunately, Dr. Jones was not particularly supported in developing the “fine art of medicine” during residency training and thus may seem distant and technical in dealing with patients. All is not lost, however, as Dr. Jones has acquired a senior otolaryngologist mentor in his new practice setting, who is respected for her physician personhood and known to be very focused on virtues and ethics in patient care.

In the first missed opportunity, Dr. Jones was very technical in his explanation of potential outcomes when asked by Reverend Smith. In general, we use population-based data to practice sound evidence-based medicine. But it should not be the only factor in discussing outcomes with a concerned cancer patient. The question was a perfect opportunity for Dr. Jones to further explore Reverend Smith’s views on quality of life, personal visions for his future, and perhaps how his wife’s cancer impacts his own sense of family and their life moving ahead. Second, Dr. Jones appeared inconsiderate or clueless when he tried to joke about not being “God” when discussing outcomes with Reverend Smith—the wrong statement to the wrong patient at the wrong time.