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A study of the impact of technology on doctor-patient relations in the US has found that having a computer in a doctor's surgery widens the gap between the good and bad communicators in the US medical profession.

The research was carried out by medical sociologists at the University of Indiana. They analysed 54 patient visits before and then twice after they had computers installed in their rooms.

As well as determining that it wasn't a great idea to install computers in the corner of the room, so that the doctor's back was to the patient (good work there), the researchers found that poor communicators used their PC as a kind of shield between themselves and their patient.

Those doctors who already had an easy rapport with their patients used the computer to help keep the patient informed about their visit, showing them the screen to share information about drugs or lab results. They also took the opportunity to clarify medical records when patients pointed out errors or discrepancies.

By contrast, the less socially able clinicians seemed confused when the information on their computer disagreed with something the patient said. The computer, rather than the patient, was their main focus.

Richard Frankel, lead author of the study, told CIOInsight.com that doctors: "have to move to the computer record being seen as an educational tool, not notes to self". He added that the poor communicators should not abandon technology, but should just be made aware of the issues: "It's a relatively simple thing to encourage clinicians to turn the screen and make eye contact," he said.

The research will be published in the August issue of Journal of General Internal Medicine. ®

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