Some­times it seems as if tech­nol­o­gy is tak­ing over hu­man func­tions—usu­al­ly, in my ex­pe­ri­ence, with dire con­se­quences. Every month I at­tempt to pay my bills on­line, and every month I end up vexed with some lo­cal agency. This month the sys­tem works; next month you can’t get in and have to call some­one, which means wait­ing end­less­ly. The op­er­a­tors are help­ful and pa­tient, though—their job must be a thank­less one. Or, you pay reg­u­lar­ly for three months with no prob­lem, and sud­den­ly get a bill say­ing you haven’t paid for two months and your phone or in­ter­net is about to be cut off. Then you have to go down­town, usu­al­ly los­ing half a day, and if you’ve mis­placed a bill, it be­comes even more dif­fi­cult to fix the prob­lem.

A sim­i­lar sit­u­a­tion is hap­pen­ing in med­i­cine in Trinidad and To­ba­go. The oth­er day, an ex­pe­ri­enced moth­er brought in her thriv­ing, breast­fed two-week-old new­born, who had gained eight ounces since birth, de­spite be­ing told she should not breast­feed be­cause the ba­by’s blood sug­ar at birth was low. For­mu­la had been start­ed against her ob­jec­tions in the nurs­ing home, so she took her ba­by home the next day and breast­fed him ex­clu­sive­ly, as she had done with her pre­vi­ous three chil­dren. There was no prob­lem.

As she said, “Who ever heard of a healthy new­born ba­by’s blood sug­ar be­ing test­ed?” That’s a good ques­tion. There are no or­gan­i­sa­tions in the world that rec­om­mend rou­tine test­ing of healthy new­borns’ blood sug­ar af­ter a nor­mal preg­nan­cy, labour, and de­liv­ery. But the tech­nol­o­gy is avail­able, so peo­ple seem to think it should be used.

In­ter­est­ing­ly, stud­ies show that when a new­born’s blood sug­ar is low, the best treat­ment is the moth­er’s colostrum—the milk of the first few days af­ter de­liv­ery—not glu­cose wa­ter or cow’s milk for­mu­la.

This em­pha­sis on tech­nol­o­gy, rather than on what the doc­tor is smelling, see­ing, feel­ing, hear­ing, and touch­ing, seems to be the norm now—and wors­en­ing. It is com­pound­ed by the prob­lem the Med­ical Board is hav­ing in get­ting new­ly grad­u­at­ed doc­tors to obey spe­cial­ty re­quire­ments, in­stead of putting up signs claim­ing they are spe­cial­ists be­cause they worked for a few years in a spe­cial­ty and know how to re­quest tests.

The Sec­re­tary of the Med­ical Board of Trinidad and To­ba­go, Dr Ian Ram­nar­ine, in an Ex­press ed­i­to­r­i­al of No­vem­ber 3, “Doc­tors in the Dig­i­tal Age,” urged the pub­lic “to ver­i­fy the cre­den­tials of any­one claim­ing to be a med­ical doc­tor or spe­cial­ist.” That ap­plies to any spe­cial­ty—surgery, ob­stet­rics/gy­nae­col­o­gy, pe­di­atrics, in­ter­nal med­i­cine, pub­lic health, and many sub­spe­cial­ties such as der­ma­tol­ogy, car­di­ol­o­gy, nephrol­o­gy, gas­troen­terol­o­gy, ENT, oph­thal­mol­o­gy, and more.

To do this, Dr Ram­nar­ine ad­vised the pub­lic to use the Med­ical Board web­site to ver­i­fy a prac­ti­tion­er’s stand­ing be­fore un­der­go­ing surgery with some­one claim­ing to be a spe­cial­ist. Any­one claim­ing to be a spe­cial­ist but not ap­pear­ing on the web­site should be re­port­ed to the Med­ical Board. That, to me, is ap­pro­pri­ate use of tech­nol­o­gy.

In fact, this rule should ap­ply to all para­med­ical branch­es: psy­chol­o­gists, phys­io­ther­a­pists, au­di­ol­o­gists, speech ther­a­pists, oc­cu­pa­tion­al ther­a­pists, and oth­ers.

It makes you won­der if there is a re­la­tion­ship be­tween the overuse of new tech­no­log­i­cal gad­gets and re­fusal to fol­low Med­ical Board re­quire­ments. It should al­so make you re­flect on the pro­lif­er­a­tion of para­med­ical prac­ti­tion­ers in Trinidad and To­ba­go over the last 20 years.

It’s not on­ly about check­ing new­born blood sug­ar. Mod­ern bed­side med­ical in­stru­ments are use­ful for screen­ing in­fants for jaun­dice, oxy­gen lev­els, or rare hip prob­lems in the first month of life. But some moth­ers now mea­sure their tod­dler’s blood oxy­gen at home when the child has a cold or cough, with­out un­der­stand­ing what the lev­els mean—re­ly­ing on­ly on Dr Google or Pro­fes­sor AI. A pat­tern may be emerg­ing: tests are be­ing done sim­ply be­cause they are avail­able, not be­cause they are need­ed.

The up­shot can be anx­i­ety, wor­ry, un­nec­es­sary ex­pense, and the de­vel­op­ment of Vul­ner­a­ble Child Syn­drome (VCS)—when a par­ent per­ceives a child as be­ing at high­er risk for health, de­vel­op­men­tal, or be­hav­iour­al prob­lems than is ac­tu­al­ly the case. VCS can lead to over­pro­tec­tive par­ent­ing, dis­pro­por­tion­ate med­ical at­ten­tion, and anx­i­ety that neg­a­tive­ly im­pacts a child’s de­vel­op­ment.

Tech­nol­o­gy is use­ful—but it must be used ap­pro­pri­ate­ly, by both med­ical prac­ti­tion­ers and the pub­lic.