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November 1, 1976

Deus Ex Machina in Perspective

Author Affiliations

Director Department of Computer Systems in Medicine, AMA

JAMA. 1976;236(18):2099. doi:10.1001/jama.1976.03270190055037

In his August 16, 1976, JAMA editorial entitled, "Are Medical Schools Neglecting Clinical Skills?" George L. Engel, MD, suggests that the clinical acumen of recent medical school graduates suffers substantially due to reliance upon technological support mechanisms.1 The debate concerning clinical and economic efficacy of technologic innovation has become intense in recent times, particularly as legislation holds the promise of transferring control over medical technology from the medical environment to governmental bureaucracy. To the debate, Dr Engel adds the concern that technology has eroded the clinician's ability to render sound, intellectual judgment.

Reliance upon a computer or other mechanical contrivances to develop clinical data may portend the diminution of clinical skills, and there may be the potential for educational deficits concerning the conceptual determinants upon which mechanized clinical data development is predicated. However, to impute causality for these prospects to an overabundance of technology represents a non sequitur that