This post is inspired by recent events, when I was approached to moderate a controversial discussion with an expert panel at an international health innovation event in Europe. The topic featured: “Disruptive Innovation in Medicine: Will physicians soon be obsolete?”
Science Fiction – for real?
50 years ago the original TV series “Star Trek” introduced a most fascinating and visionary healthcare device, the ‘Tricorder.’ Remember how Doctor McCoy (and his successors in more recent Start Trek versions) perform comprehensive medical examinations by simply moving the device over the patient’s body to diagnose their condition?
This technology is now becoming reality, user test are scheduled to start in September 2016. – The question is, how will it influence the medical profession? Will we need physicians in the future and if so, will their work be different for what they do today?
Stuck in today’s medical factory model
Let’s take a quick step back to look at why the Tricorder changes the paradigm of the past centuries as well as our current healthcare system, where the physician plays a key role to diagnose and treat our illnesses.
The internet led to a decline of our reliance on the medical experts around us (at least for the bulk of non-emergency care). Patients and caregivers discovered the abundance of online content to gain broader and deeper insights into health topics, to find up-to-date research information or to explore new treatment options. Global online communities of patients and caregivers form around numerous illnesses to share and exchange information and individual experiences across disciplines and borders.
Nowadays patients often enter a doctor’s office armed with research results and specific therapy options as well as a keen awareness of their own economic power pushing the physician towards delivering on the patient’s specific requests. From a patient’s perspective, in many cases, the physician degraded from a consulting health professional to a dispenser for prescriptions.
The physician on the other hand is limited by what diagnosis and treatment options the payers allow, i.e. are willing to pay for, and remains trapped spending much time to navigate a bureaucracy established by the various insurers and payers. Not being able to focus on practicing medicine but distracted by administration is frustrating also for physicians, who have stepped up to improve the patients’ health to the best of their abilities.
It does not surprise that a typical medical practice -from a patient’s perspective- looks like a factory: the patients get lined-up while the doctor hops from one to another in an efficient flow spending minimum time on each individual.
Overall, we already know our healthcare system being not overly efficient and way too expensive. From a patient’s perspective, it’s focus feels far off their individual health and care.
Beyond the limits of human capability
Even the best trained physician remains a human being with biases and limitation just as everyone else. We can also not realistically expect a physician to keep up with the 5,000 latest research articles on heart disease alone, to digest and interpret them as well as translating them swiftly into their medical practice.
At the same time, computers with artificial intelligence (AI) and deep learning algorithms are already becoming capable of providing better and more treatment options with fewer errors with quick access to the internet’s vast sources of medical data and the most recent healthcare information for all kinds of user groups.
The picture is not much different for the “self-informed patient.” It is in the nature of the (online) beast that some information sources are more credible than others, which induces significant risk for layman consumers of this information. Incomplete, cherry-picked and at times questionable, outright wrong or inapplicable medical information in untrained hands can do more ill than good for the patient.
It’s a race that humans cannot win anymore, neither patients nor doctors.
The next step: Fiction becoming reality
The Tricorder can be seen as a way as the next evolution of automation – scary as it might sound initially, freeing up the physician and medical staff for other tasks may not be a bad thing.
It is a big step towards ‘automating healthcare’ by building an affordable and mobile diagnostic device that can reliably detect the presence or absence of an array of common illnesses better than an individual physician. This is what the ongoing Qualcomm ‘Tricorder’ X-Prize challenge is about.
What the final design will look like, we will see. Here is a glimpse by two of the seven finalist teams.
It awards $10,000,000 for a mobile device that cover vital signs, consumer experience, and diagnostics across a set of 12 distinct diseases as well as their absence. In fact, the winning device needs to cover indications from a variety of medical fields (see below table, source: X-Prize) with its results beating ten board-certified physicians.
The winner(s) are to be announced in just a few months out. To my surprise, this groundbreaking innovation challenge goes widely unnoticed – at least in Europe, from my recent observation.
A new side of healthcare
The Tricorder will only be the first version of a new class of healthcare technology. The first Tricorders may become available at the entrance to hospitals, medical practices, workplaces or in public health kiosks already in place at Walgreen, CVS and there alike over the coming years. They may pop up everywhere you hang out and have a few minutes to spare. Perhaps, you will have to undergo a quick screen of your health status to ensure the absence of contagious diseases before entering areas with many or vulnerable people such as nurseries, retirement homes or entertainment events.
Imagine how fast the second and third version will aim high with added features, miniaturization, better portability, user convenience, lowering cost, and so on. Order your own Tricorder via Amazon or pick it up at BestBuy or the Apple store. Some of its functionality may become available part of your next ever-smarter smartphone, smartwatch or other wearable device.
As a bottom-line, you will no longer need to see your doctor for a diagnosis. You may even collect relevant vital signs or perform a laboratory test on your own device anytime and anywhere.
Medical doctors – a dying profession?
With technology delivering affordable quality results, the key question remains: what happens to the physicians and their staff if key responsibilities such as a reliable diagnosis and selecting the most promising treatment may no longer be in their job description?
It seems obvious that most of what doctors and their administrative helpers do today may not be needed in the future. We already see trends emerging that drive radiologists, for example, out of their diagnostics business:
- Cancer Research UK crowd-sourced identifying cancer by asking citizens to participate and commissioning a Genes in Space game for mobile devices designed to actually map patterns that help scientists spot DNA faults.
- In recent competitions artificial intelligence (AI) systems get “strikingly close” to humans in detecting breast cancer, for example.
Where did the medical doctors go?
Technology will take over triage, diagnosis and decision-making regarding treatment options. Much of the administrative staff becomes obsolete. Fewer doctors will be needed. Their focus shifts to delivering the much-needed empathetic human care – and this may not be a bad thing, since this critical field of care seemed to have lost its place in the medical practices today.
It will open a new competition with nurses who already occupy much of this care space today and at a more affordable cost. Where exactly the line will be drawn time will tell.
My question to you
– How do you envision the future of medical professionals to change?
Please share your thoughts!