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Medicine Robotics

A Doctor Remotely Told A Patient He Was Going To Die Using A Video-Link Robot (bbc.com) 223

dryriver quotes the BBC: A doctor in California told a patient he was going to die using a robot with a video-link screen. Ernest Quintana, 78, was at Kaiser Permanente Medical Center in Fremont when a doctor — appearing on the robot's screen — informed him that he would die within a few days. A family friend wrote on social media that it was "not the way to show value and compassion to a patient". The hospital says it "regrets falling short" of the family's expectations.

Mr Quintana died the next day.

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A Doctor Remotely Told A Patient He Was Going To Die Using A Video-Link Robot

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  • by mykepredko ( 40154 ) on Saturday March 09, 2019 @09:41PM (#58245210) Homepage

    For years, here on /., there have been stories about how people use technology - I think the first time was Radio Shack laying off employees: https://slashdot.org/story/06/... [slashdot.org]

    I guess that you can see why people use technology to avoid unpleasant situations, but they should be highlighted as being inappropriate with the message being that like a Stark, "The man who passes the sentence should swing the sword."

    • This is just a teleconferencing video call.

      The fact that it was connected to a robot is just to make a clickbait headline.

    • by Solandri ( 704621 ) on Sunday March 10, 2019 @03:35AM (#58246218)

      but they should be highlighted as being inappropriate with the message being that like a Stark, "The man who passes the sentence should swing the sword."

      The doctor wasn't the one who gave him the disease. I'm having trouble finding out what this "chronic lung disease" was - it seems to be omitted in all the news reports (the quality of journalism has fallen markedly in the last few decades). If it was smoking-related, the guy did it to himself.

      The appropriate catchphrase here is "shooting the messenger." I get that the family and the guy were upset to find out he'd be dying so soon, but there's no reason to take it out on the doctor. The doctor was only the messenger.

      Put another way, would they rather have found out via video conference and had 48 hours to spend together and prepare for the end? Or would they have preferred to lose 10%-20% of that remaining time waiting until a doctor could deliver the news in person? Given the short timeframe of the diagnosis, I think informing them ASAP by any means possible should've been the priority.

      • by grumling ( 94709 )

        So there's a total of one doctor in the whole hospital? I get it that "his doctor" wasn't available when the test results came in, but a visit from an associate who's on duty would still be more personal. The video conference could have happened between the two doctors so they could get the story right.

  • by iggymanz ( 596061 ) on Saturday March 09, 2019 @09:42PM (#58245222)

    A remotely controlled machine is not a robot. The voice telling him he would die was the doctors. He spoke the truth. If you can't handle the truth of someone near death's fate stay out of hospitals. Life is cruel and a bitch, then you die.

    • Not quite, robots can be internally or externally controlled from a control unit. whether that control unit is a computer or a human is irrelevant to whether the thing itself is a robot. It's a tele-presence robot.

    • If you can't handle the truth of someone near death's fate stay out of hospitals.

      Likewise, if you cannot be bothered to take the time to tell your dying patient the truth in person then don't be a doctor. The problem here is not that the patient can't handle the truth it's that the doctor either didn't care enough to tell his patient in person or was, himself, unable to handle a serious conversation like this.

    • by SirSlud ( 67381 )

      Life is cruel and a bitch

      That's certainly how it seems to dipshits.

    • So which part of the spectrum are you on?

    • The problem isn't that the doctor used a video link to tell this guy he was going to die. The problem is the guy didn't have access to health care that would have told him he was seriously ill sooner than 24 hours before he was going to die.

      • by tomhath ( 637240 )
        The guy was 78 years old, he would have been on Medicare for at least 13 years. That seems like plenty of time.
    • For some reason the term telefactor has never caught on. That's the correct name, if you don't want to just say computer screen, or video conference. (Did it have manipulators? Then it's a telefactor.)

  • by PopeRatzo ( 965947 ) on Saturday March 09, 2019 @09:44PM (#58245234) Journal

    I went to the doctor and he examined me and ran a battery of tests. His video link robot came back into the room and said, "Mr Ratzo, you're crazy." I told him I wanted a second opinion and he said, "You're ugly, too."

    But the video link robot did suggest that I start doing yoga. When I asked him why, he said, "So you can kiss your ass goodbye."

    • "Doctor, tell me the truth! How long do I have to live?"

      "You have... ten."

      "Ten what, doctor? Months? Weeks? Days?!"

      *checks wristwatch* "Ten... nine... eight... seven..."

    • by JustAnotherOldGuy ( 4145623 ) on Saturday March 09, 2019 @11:55PM (#58245690) Journal

      A dying man smells his favorite oatmeal raisin cookies cooking downstairs. It takes all the strength he has left but he gets up from the bed and crawls down the stairs.

      He sees the cookies cooling on the counter and staggers over to them. As he reaches for one, his wife's wrinkled hand reaches out, smacks his and she yells:

      "No, you can't have those! They're for the funeral!"

    • A beautiful woman walks into a doctor's office one day and the doctor is bowled over by her stunningly good looks and all his professionalism goes right out the window.

      He tells her to take off her pants, she does, and he starts rubbing her thighs.

      "Do you know what I am doing?" asks the doctor? "Yes, checking for abnormalities." she replies.

      He tells her to take off her shirt and bra, she takes them off. The doctor begins rubbing her breasts and asks, "Do you know what I am doing now?", she replies, "Yes, checking for cancer."

      Finally, he tells her to take off her panties, lays her on the table, gets on top of her and starts having sex with her. He says to her, "Do you know what I am doing now?"

      She replies, "Yes, getting herpes - that's why I'm here!"

  • by SeaFox ( 739806 ) on Saturday March 09, 2019 @09:48PM (#58245244)

    I like the story immediately preceding this one is "Is Bad Customer Service More Profitable Than Good?"

    • by gweihir ( 88907 )

      Seems pretty relevant. Although to be fair, in this case here they already knew they would be losing the customer. They will probably not get any business from his family and friends in the future though.

      • by hazem ( 472289 )

        They will probably not get any business from his family and friends in the future though.

        As if Americans have much choice about where they get their medical coverage. Most get the insurance their employer provides and can't afford to go "outside of network" because it's ridiculously expensive to do so. With this one being KP, they can only go to a KP facility and they'll get the providers KP decides they'll get.

  • Cowardice (Score:3, Insightful)

    by gweihir ( 88907 ) on Saturday March 09, 2019 @09:48PM (#58245246)

    Yes, I get that telling this to a patient is hard. But if you cannot do it in person, then do not be a doctor or do pathology were patients are already dead.

    • I'll give the doctor the benefit of the doubt. Perhaps he was busy trying to save someone else who had a chance of living and didn't have time to sit around trying to comfort someone whose time was up.
      • by gweihir ( 88907 )

        The person that failed this guy was not the expert on the telepresence device, although he should probably have refused to do this in this way. The doctor that failed him was his own, on-site doctor.

        • The doctor that failed him was his own, on-site doctor.

          I'm sure there was absolutely nothing better he or she could be doing with his or her time than telling someone who had none left that same very fact. There's a finite number of doctors with a finite amount of time and that time is probably of more use elsewhere.

          In fairytale world, I'm sure the doctor could have come and spent several hours with the man giving him some life affirming realization so that he was able to come to terms with his own mortality and find peace in his final moments. Meanwhile in

    • Re:Cowardice (Score:5, Insightful)

      by stephanruby ( 542433 ) on Saturday March 09, 2019 @10:19PM (#58245372)

      Maybe it was just pragmatism, not cowardice. The patient died the very next day. It's very possible that the patient was already in hospice care and that the doctor couldn't get to the patient in time to tell him the diagnosis in person.

      In the case of my mother, the homecare hospice nurse is the one that told us that she only had three days left to live (based on the discoloration of her skin). And her prediction was remarkably accurate. She had been battling lung cancer for the last three years, so it's not like this came as a surprise to any of us. But the headsup from the nurse is what allowed my brother to fly in to see her one very last time.

      • by sjames ( 1099 )

        They could have had a nurse physically present when the robo-doc gave the news.

    • So you're saying it would have been better for the doctor to not tell the video consult patient that he's about to die, rather tell him to make an in-person appointment knowing the patient is likely not going to live long enough to make the appointment?!? The patient in this case died the next day, so even if they had an appointment that day they wouldn't have made it.

      • It is even worse than that, the decision that had been made was that nothing could be done except comfort care; waiting to tell him would have meant withholding the comfort care, too! He would have suffered more that way.

    • Yes, I get that telling this to a patient is hard. But if you cannot do it in person, then do not be a doctor or do pathology were patients are already dead.

      I dunno. I could really care less who told me I was going to check out. Way too much is made of the sensitivity aspect, and half of the other crap around death. I cringe when I read about how so and so "passed away peacefully surrounded by family". Screw that. I've done the other side of that equation enough times, and it's seldom all that peaceful, and I intend to check out all by myself.

      So if someone on Mars tells me I've only got a few hours, or in person - I'll thank them, have a shot of tequila, s

    • Re:Cowardice (Score:5, Informative)

      by Darinbob ( 1142669 ) on Sunday March 10, 2019 @01:01AM (#58245888)

      Did you just read the headline, or only read the summary? Read the article maybe. The patient died the next day, the phone call was made apparently soon after getting the MRI results and the phone call was in the evening and the doctor had presumably gone home. So, wait until the next day to give an update to the patient, do a voice only call, or do a video call?

      For me I'd rather get the news sooner that the condition was inoperable. More time to get other family notified. The real fault was that this was done without having an additional medical professional in the room at the time which was standard procedure for the hospital.

    • It's more likely the doctor was pressed for time, constantly pushed by his employer to do more, especially now that a 'robot' was helping him.
    • Can I interest you in a jump to conclusions mat? Or did you out yourself as the doctor in question? It has to be one of those two since based on your ability to come up with that conclusion you either know, or think you know far more than the very little and only one sided information given in TFA.

    • by tomhath ( 637240 )

      But if you cannot do it in person, then do not be a doctor

      This doc screwed up by not asking someone who was there to handle it. Hospitals all have end of life counselors, clergy and social workers available to help.

    • Comment removed based on user account deletion
  • It's Kaiser (Score:4, Interesting)

    by TechyImmigrant ( 175943 ) on Saturday March 09, 2019 @10:00PM (#58245278) Homepage Journal

    It's Kaiser Permanente. What did you expect? Resources wasted seeing a patient in person, when they were going to quit paying fees in a few days anyway?

    • Naw, Kaiser Permanente is a great system. Lower cost but with good care and preventative medicine.

      • Naw, Kaiser Permanente is a great system. Lower cost but with good care and preventative medicine.

        I have a family member who worked for Kaiser and quit in disgust at their unsafe care practices.

  • The article immediately preceding: "Is Bad Customer Service More Profitable Than Good?"

  • I'm in my gown, backside sticking out, got into the position, doc did his bit, said I looked good, and left.

    As the doc left the nurse came in and said "Who was that?"

    / here all week
    // actually told that joke to a friend who is a retired nurse
    /// she didn't laugh, said that kind of thing happened all the time.
    • by PPH ( 736903 )

      I was diagnosed with a very contagious disease a while ago. The doctor told me that I would be put on a strict regimen of pizza and pancakes. I asked if that would really help my condition.

      "I don't know", he said. "But that's the only food we can slide under the door."

    • There's an old SNL skit like that but instead a guy is getting checked for a hernia. In the end he's surrounded by a crowd of people all with a hand cupping his bits and asking him to cough when the real doctor walks in and scares them off.

  • What would have had to happen for the doctor to visit this patient in person? For instance, was he doing lift-saving surgery that afternoon in another hospital? Or just that he had many patients to make contact with in the short time between two other surgeries? There are many situations that would mean that this doctor could not have personally visited this patient.

    So, what should the doctor have done? Not used the tech would mean not making contact with the patient at all. Had a nurse go see them, a nurse

    • was he doing lift-saving surgery

      Yes, on someone with elevatord blood pressure.

      TY,IHAW, etc.

    • by sjames ( 1099 )

      So, what should the doctor have done?

      Gotten a nurse or even the hospital chaplain to accompany the bot when he delivered the bad news.

  • by h33t l4x0r ( 4107715 ) on Saturday March 09, 2019 @10:12PM (#58245334)
    "what's the bad news?" he asked the robot doctor.
    "That number is in binary and I've been trying to get in touch with you since yesterday"
  • Just because we can do a thing, does not mean that we should do that thing. This is going to become more and more of an issue in the years to come.

  • by timholman ( 71886 ) on Saturday March 09, 2019 @10:27PM (#58245414)

    This story is pure one-sided clickbait.

    There's no way that this man, and his family, were not aware that his condition was critical. The doctor (who might have been hundreds of miles away) made the correct decision to inform the patient immediately of his prognosis.

    Being there in person wouldn't have changed a thing. Quite the contrary - the patient very probably would have died waiting for the doctor to show up in person to tell him exactly what he and his family almost certainly already knew - that his life was about to end.

    This is a story designed to make an insurance company look evil. There may be plenty of valid reasons to hate Kaiser Permanente, but this incident was not one of them. Note from the article: ""The evening video tele-visit was a follow-up to earlier physician visits." The family in fact did have previous personal consultations, where I'm sure they were told what to expect if the test results came out badly. The tele-visit was the doctor following up with them in as timely a manner as possible.

    • Re: (Score:3, Insightful)

      by Anonymous Coward

      My oral surgeon used an ancient VHS tape to tell me having my wisdom teeth removed might fuck up all feeling in my jaw. Who do I see about being outraged?

      You're absolutely right. This story is another tempest in a teacup.

  • by Applehu Akbar ( 2968043 ) on Saturday March 09, 2019 @10:51PM (#58245492)

    Had Mr. Quintana's insurance company been Humana, they would have just posted a comment on his Facebook page.

  • "Mr Quintana died the next day."

    Well at least he got that part of it right.

    I'm only surprised that the robot didn't hand him a "How To Cope With Your Impending Death" pamphlet.

  • So what WOULD have been the proper alternative here?

    Disconnect the robot, take an hour to drive over while the patient waited and then tell her she was going to die in person? Somehow that doesn't sound all that good either.

  • So all that is needed to give the situation some humanity would be to have a nurse stand next to the robot and repeat what it says. It doesn't even need to be a nurse, it could easily be done by a desktop tech from IT who was in the area.

    • A Nurse did escort the tele-presence device into the room. The hospital uses the machine for the late shift so they can have a Doctor, they can't afford to have one physically present on site.

  • ... a screen inviting the patient to swipe a credit card?

  • At least he was diagnosed correctly.
  • I'd be a bit more concerned with the level of care rather than the method of delivering any bad medical news. One of the reasons (in theory) for telepresence is so that you can consult specialists nationally/internationally without them spending hours/days traveling for each patient when they could be lending their expertise to numerous patients in that same time period. I'm not sure if this specific situation fits that scenario, the specialist could live next door to the hospital for all i know, and even

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