Computers in Medicine

IT IS time for an office practitioner to comment on the rash of recent literature on computers in medicine.¹⁻⁴Indeed, it is appropriate to ask if many office practitioners read these articles with any practical interest. INTERNIST-1, the chest pain protocol, INFERNET, ONCOCIN, and so on are unlikely to be used by most of us. As their respective authors correctly point out, they are at present mainly research tools, and teach us a lot about how medical reasoning works—principally from the computers' shortcomings. Thus, it is comforting to learn that INTERNIST-1 also has difficulty reasoning temporally, anatomically, and pathophysiologically at the same time. Nonetheless, it is clear that computers are here to stay, and not just at busy emergency rooms or the university hospitals. Because of the incredible price breakthroughs, it is likely thateverymedical practice will employ or share one within the next few years. The computer