“Big Brother” in Medicine

I truly enjoyed 1984. Such a great book, a century ahead of its time, and predicting our future. Today more than ever, the potential ability for the most famous quote of George Orwell’s 1984 has never been truer “Big Brother Is Watching You.” However, what if instead of being afraid of Big Brother, you embrace him. I love my Big Brother, and he is always looking out for me. In medicine, Big Brother can be your advocate keeping us physicians in check.

Unfortunately, medical errors are the 3rd leading cause of death in the United States. A 2016 study from John Hopkins estimated 250,000 Americans dying each year from medical errors. Luckily, I see this problem fixed in the future with technological advances. When I first started practicing, writing orders by hand with dosages for a pharmacist to interpret was the norm. With electronic medical records (EMRs), the writing is easily readable. Furthermore, Big Brother (EMRs) have safety features available correcting the appropriate dose, considering your kidney function, cross verifying for potential interactions with other allergies you may have, essentially being your Big Brother to prevent these errors. Although EMRs get a bad reputation, I compare it to my real big brother which I initially hated but realized the love and guidance he wanted for me.

More recently, I have been more excited about the capabilities of Big Brother. With artificial intelligence, not only will EMRs be able to check dosing, allergies, give guidance for clinical scores, but act independently and give an AI diagnosis to compare with yours. Already Radiology, Dermatology, Ophthalmology, and Pathology have published studies adding AI assistants to physicians. Medical errors bring heavy costs to society. Although it seems scary to let Big Brother into medicine, he may save your life.


Cesar O. Avila, M.D. FACEP