The devolution of the GP’s role continues with a little help from the computer.

LIFE is unfair. Charles Darwin gets permanent top billing on the fame charts for proposing his theory of evolution. Meanwhile, I don’t even get a mention for uncovering the real fact of evolution: namely that everything devolves, but not at the same speed. 

On the slow end of the scale are things like hem lines (changing over years). In the middle are things like pop stars (receding on an annual cycle). On the very fast end of the scale are topics like the medical workforce. 

I would like to write about the folly of excising GPs from medical care, but readers are no longer interested. Today’s question is: Can we take all human beings out of medical care?

Yes, according to the folks at the Clinical Research Unit for Anxiety and Depression at St Vincent’s Hospital, Sydney. 

They are convinced that both GPs and psychologists are obsolete. They claim the most common mental health complaints are treated just as successfully (or perhaps unsuccessfully) with a "respectful" computer as with human care providers. So why not just save the Medicare rebates?

Now, during my training I remember learning about a wide variety of different psychotherapies. I was puzzled. How did one know which therapy to apply to a particular person? 

I was told by my supervisor: "It’s not the method; it’s the relationship."

So now it’s the intimate interaction one has with one’s computer that provides the potential for healing. Let’s turn to the Internet and a set of cartoon caricatures for guidance. Just press the F1 key if you want an audible sigh from your computer, F2 for a face that pops up and nods in the affirmative. This is all very respectfully rendered – a fully functional digital doc, not reserved just for rectal exams. 

Can I accept this? Sure. My computer therapist advises me to take several deep breaths and remain calm. 

I think back to Harlow’s classic experiments with infant rhesus monkeys raised on surrogate mothers made from lactating wire effigies. 

The monkey infants whose surrogate mother was wrapped in soft terry cloth developed more normally than those whose surrogate consisted only of bare metal.

In keeping with this evidence, I propose that we offer padded shoulder-like devices for attachment to computer screens. Patients could feel as though they had a comforting place on which to cry, as they soldiered along, self-managing, according to prompts on the screen.

Dr Pam Rachootin

Adelaide GP, journalist and teacher.