With improved technology, especially, Artificial Intelligence, what physicians will be needed in the future?
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Technological advances like Star Trek’s “Tricorder” affect healthcare faster and deeper than we seem to be aware of. It poses the legitimate (and serious) question whether we will need physicians anymore in the future!
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!
Meant to raise questions and serving as a learning opportunity for graduate students in academic program around the globe, this case study lifts the corporate curtain a bit to show how innovation through intrapreneuring really happens and decision points along the way.
The newly appointed director of Innovation Management & Strategy at Boehringer Ingelheim, a German-based multinational pharmaceutical company, is finding his way forward in his firm’s new, first-of-its-kind role, which is central to the company’s growth rejuvenation strategy. His job has a threefold mandate: to build internal networks, to establish internal structures and to leverage internal ideas. His biggest challenge, however, may be transforming the organization’s DNA. The blockbuster business model that has characterized the company for decades is no longer appropriate. Instead, the firm needs to develop healthcare products available to end users over the counter. This shift in strategy requires innovative changes in distribution, delivery and customer focus. To accomplish this goal, he needs to institutionalize innovation so that it becomes sustainable. But in doing so, he must also identify the metrics for assessing progress. The case provides an opportunity for students to step into the shoes of an innovation leader, to develop an innovation roadmap for the organization in the face of uncertainty and to understand how to engage in innovation leadership at various levels of a global enterprise.
This case has two key objectives. First, this case provides students an opportunity to grapple with the difficult decisions associated with innovation in an uncertain environment. Second, this case highlights that anyone has the ability to cultivate an entrepreneurial mindset and to lead innovation. The case divides the attributes of an innovation leader into five components: observing, questioning, experimenting, networking and associating. It shows the real-life experiences of a manager doing seemingly routine activities, who evolved into a leader who transformed the DNA of a global enterprise. The case also provides a template of the tasks, responsibilities and value-added changes as an individual moves progressively within an enterprise from an operations manager to a senior manager to an innovation leader. This case can be used either toward the beginning or toward the end of any course that addresses innovation and creative thinking in a large organization. At the beginning of a course, it illustrates the challenges of acting in the face of uncertainty in a large organization. At the end of a course, the case provides an opportunity for students to apply what they have learned about innovation, entrepreneurial thinking and innovation leadership.
When we talk about disruptive innovation, we can easily agree that going from the days of dim candle light and sooty oil lamps to electric light was one of these breakthrough innovations, right? Its icon, the lightbulb serves as our symbol for a great idea today.
Who invented the lightbulb?
When you ask around “who invented the lightbulb?” the answer “Thomas Edison” first comes to mind – and the answer is wrong! Truth is that we can give credit closer to 20(!) inventors of the lightbulb! – How so?
Thomas Edison patented the first practical and commercially viable incandescent lightbulb in 1878 and a revised design in 1879. In addition, he offered the first efficient electricity supply system for households and businesses, which laid the foundation and cleared the path for mass-producing light bulbs in 1880. His design was an evolution from previous, inferior designs and enabled by improved technology.
Sitting in the dark without Edison?
No worries, we would not stay sitting in the dark. It appears safe to say that even if Thomas Edison was never born, the practical incandescent lightbulb would have been developed around the same time – by someone else.
Looking back in history, Humphrey Davy invented electric light in 1802; more than 75 years before Edison. His “arc light” was unsuitable for mainstream application though it found specialty uses even today. Many more designs for incandescent light and lightbulbs were developed by several inventors, but neither were they practical nor suitable beyond demonstration stage. Prominently, Joseph W. Swan built a working prototype of a “light bulb” in 1850 – well before Edison.
Edison had access to improved technology such as a better vacuum pump for his breakthrough design. This technology was not available to previous inventors. Edison also developed an efficient and economical way to distribute electricity when earlier designs drained batteries quickly. (A nice example, by the way, on how a product can go a long way when bundled with a complementing service.)
On the flip-side, Edison knew of his limitation too. He made carbonized Japanese bamboo glow as filament between two electrodes knowing that carbonized Tungsten was the superior material. However, the technology was not available at the time to produce a thin Tungsten thread. We had to wait for William D. Coolidge to produce the Tungsten filament for General Electric in 1910, which is still the preferred material to illuminate our modern incandescent lightbulbs today.
This situation is typical and comparable to many big ideas that entrepreneurs work on today. There is much competition among entrepreneurs, so every good idea usually has a handful of teams working on it independently and head-to-head at the same time. Thus, it is highly likely that, if not Edison, another inventor would have come up with the lightbulb design we are so familiar with today.
R&D as a Legacy
Perhaps, the even more impactful and lasting heritage of Thomas Edison are not his inventions, useful as they are. His products such as the lightbulb, phonograph, quadruplex telegraph, mimeograph, etc., have been replaced over time by more advanced technology.
Nonetheless, Edison has changed the way we discover concertedly today. Until his time, inventors matched the stereotypical image of a lonely genius experimenting and inventing in their lair burning the midnight oil over some ambitious idea. Edison established the first research and development (R&D) organization in his famous Menlo Park lab, where a large number of researchers worked together in an orchestrated way to find solutions to specific problems coordinated strategically and systematically concerted. Edison has industrialized research!
Until today every research-driven company or organization worldwide follows in Edison’s footsteps! What an impressive legacy!
Disruptive innovations tend to have their origin in incremental steps and competition among inventors. First working individually and now increasingly in teams or even distributed R&D organizations across country borders.
A key success factor here is building trust and incentives within the team in order for all individual contributors to share information and findings freely.
The broader, cross-functional approach to research helps to identify ideas and technologies from other disciplines that can serve as stepping stones. Edison used a better vacuum pump, which made his design possible. Later, the capability to manufacture a thin Tungsten wire allowed General Electric to take the lightbulb the next level.
As the saying goes, “innovation happens at the intersections of disciplines.” The development of the lightbulb serves as a nice example proving it to hold true once again. Thus, innovation benefits by drawing from advances in other disciplines.
So, is disruptive innovation a myth?
Back to our original question, the story of the lightbulb is a great example for a breakthrough innovation with vast ramifications that disrupted and shaped the we live and work around the globe.
It can, however, not be seen as just one big and isolated scientific step but rather a series of many little steps in combination insights from other disciplines including manufacturing, economics and marketing leading to broad adoption that changed the world.
Only when it all comes together you have a disruptive innovation like Edison’s famous design. And it was still not the end. The journey continued to evolve with a Tungsten wire and later fluorescence, halogen and LED lights.
In this light, every disruption seems as yet another incremental step, doesn’t it?