Why Are There So Many Tools, Yet No Tools for Physicians?

Date: 03 June 2025

We live in the 21st century, where sales teams have CMS to help them, software developers have VS Code, and business owners have a plethora of tools at their disposal. Yet in medicine, it’s worth asking: what tools do doctors actually use?

Let me pull back the curtain: each day begins with consulting a densely packed Excel spreadsheet that maps out our schedule, listing each physician against their assigned services. Picture this: a department of 20 physicians managing multiple service lines over 30 days, including regular shifts, on-call duties, and both inpatient and outpatient services. The result? An incredibly complex document spanning dozens of pages. What’s more, each department in the hospital maintains its own unique spreadsheet format (naturally, given their different services). Physicians must learn these various scheduling systems—known as rotas—for each new department they rotate through, which typically happens every three months.

When we arrive at a new department, you might think we immediately start seeing patients. Not quite. First, we must log into our antiquated IT system — software that appears frozen in time from the 2000s. After locating our patient list, we begin the tedious process of reviewing medical records — examining presenting symptoms, previous admissions, medical conditions, medications, treatments, and notes from nurses and occupational therapists. It’s an endless cycle of clicking and window-switching. Only after getting up to speed with each patient’s history can we conduct examinations, provide insights, and document our findings and treatment plans, adding to the mountain of paperwork. Every task — prior authorization, prescriptions, referrals, family updates — falls to us. We repeat this process for anywhere from ten to thirty patients daily. Surgeons face an even greater challenge, balancing all of this while performing operations and documenting surgical procedures.

Yet when you dive into the start-up world, you’ll find an overwhelming abundance of innovation targeted at healthcare. There are over 100 AI scribes claiming to transcribe and summarize patient encounters with near-human accuracy. AI radiologists promising to flag subtle abnormalities on scans within seconds, and AI cardiologists can read ECGs in real-time, often catching things that may elude the human eye. There are apps for symptom checking, care coordination, prior authorization, billing, burnout prevention—you name it, someone’s building it.

But step into an actual hospital ward, and you'll quickly notice the disconnect: very few of these tools are actively in use (though I'm thrilled for the few great ones that have made it in!). Ask a doctor what their most relied-upon tool is, and the answer—almost invariably—is EPIC (or Cerner, or another EHR platform, depending on the institution). Despite all its flaws, EPIC has become the digital backbone of modern hospital systems. It is our Microsoft Word for documentation, our Excel for data tracking, our CMS for patient management—our holy grail, even if it’s a frustrating and fragile one. Until the servers go down (which happens more often than anyone would like to admit), EPIC is the one tool that doctors can’t live without.

So why, with so many cutting-edge solutions available, do we cling to the old and cumbersome? The answer lies in workflow. Every new tool that enters the system doesn’t simply integrate seamlessly—it demands the creation of a new workflow. It asks the user to adapt, to relearn, and to trust that the output is worth the input. When you’re already spending ten to twelve hours a day juggling clinical decisions, documentation, emotional conversations, and critical thinking, adding a new layer, however helpful in theory, can feel like a burden rather than a benefit.

For newly minted doctors, who are still in the process of forming their own habits and routines, adoption may be a bit easier. But for senior physicians, department heads, and administrators—many of whom have been working in the same system for decades—the idea of changing workflows can feel like trying to rewrite the base code of a legacy IBM system while it’s still running the mission-critical operation. It’s not that they’re anti-technology; it’s that they’re pragmatic. When lives are on the line, they rely on what they know works, not what might work after a few pilot projects and months of adjustment. Convincing someone to swap their tried-and-true dictation tool for a new AI scribe is more than a feature comparison—it’s a battle against muscle memory, trust, and time.

So yes, there are indeed a plethora of tools built with physicians in mind. The problem isn’t a lack of innovation — it’s a lack of adoption. Distribution in healthcare is its own beast. It’s not enough to have a great product; you have to navigate complex procurement processes, hospital politics, legacy systems, and stringent regulations. But even when those hurdles are cleared, the final challenge lies with the end-users themselves. And in healthcare, the end-user is not just a “user”—they are a person responsible for life-and-death decisions, already burdened by bureaucracy and administrative overhead.

When we address the real-world inertia of medical workflows—by meeting doctors where they are, embedding solutions into existing habits, and designing tools that truly lighten the load—we unlock an enormous opportunity. A future where doctors not only have access to cutting-edge tools but actively embrace them is within reach. This future could transform both care delivery and clinician well-being—one that I've always dreamed of working in.