Doctors in the digital age
I READ Dr. Joseph Martin's March 29 op-ed, "Digital doctoring," with great interest, but was disappointed with his assertions and conclusion. I submit that physicians have resisted and rebelled against this new era. However, the reasons he has outlined are oversimplified and do not account for all of the resistance. The fact is that medical information software is in an embryonic stage and the digital nervous systems of hospitals are immature and frequently unable to communicate with each other. This lack of communication leads to another maze that the physician must navigate .
Physicians recognize that change for the sake of change is not progress. The clinical interface of today is nothing more than an Excel spreadsheet at best. Tools of the future will be operational in nature and will guide physicians moment to moment . Real progress and greater adoption of information technology will begin when the clinical interface and tools fit the clinical processes.
Dr. JOHN H. BRAXTON
Portland, Maine
The writer is CEO of Digitalintern Solutions.
AS A patient in the Boston healthcare system, and a healthcare consultant, I strongly agree with Dr. Martin's assessment. Most physicians I see as a patient are computer literate and relatively younger. During office visits, they will have my medical record in front of them, and often make entries immediately. If a diagnostic test is required, it is electronically ordered, where the physician has a knowledge base to draw from to ensure the procedure fits the suspected medical issue.
Ironically, it was only a few years ago that IT managers at medical institutions were challenged with connectivity issues between different information systems. The industry mandated that vendors comply with standards that enabled their systems to transmit clinical information to a common medical record platform.
My recent annual physical is a good example of old vs. new. My age and gender require a certain procedure every 10 years. I was asked when it was last performed. I could not recall the date, only the place it was done at a hospital closer to me but not within the system. My physician could not readily locate the exam; it was buried in a paper archive that will soon be a distant memory.
JIM KIEFFER
Nashua
The writer is president of Proforma Financial Group.
DR. MARTIN raises the same concerns that lawyers have about the growing role of computers in our work. "Rip it out!" is how many law professors react to laptops in the classroom. No surprise, then, that a recent study I authored found that law students and lawyers have scarce opportunity to learn new skills, such as how to manage complex global teams using technology.
As in medicine, the cost of ignoring technology is high. In a nation where fewer than four in 10 middle-class Americans facing legal problems have access to an attorney (three in 10 for low-income individuals), technology can enable lawyers to meet the need by working smarter. For example, software developed at Chicago-Kent Law School helps clients fill out paperwork by translating legalese into plain English. Attorneys need more tools like this and the skill to use them.
It's easy to assume that so-called digital natives will figure it all out with time. But best practice emerges when someone bothers to study what works -- a role that medical schools have long played for doctors. Law schools today have a similar opportunity to partner with practicing attorneys to discover digital responses to the ancient call of justice.
GENE KOO
Cambridge
The writer is a fellow at the Berkman Center for Internet and Society at Harvard Law School. 
