The future of medicine is in your phone
Smartphone apps have radically changed many aspects of our everyday lives, from banking to shopping to entertainment. Medicine is next. The number of apps available in Google Play store surpassed the 1.5 million mark in May 2015. Apple store is close behind with 1.4 million apps. Interestingly, Health and Fitness category make up for over 1,00,000 of that number and has been 2014’s fastest growing app category. It is estimated that the global health and fitness mobile app market is worth about $4 billion at the moment, but this could increase to $26 billion by 2017.
Very soon , smartphones aided by innovative digital technologies, cloud computing and machine learning are going to take care of every aspect of health care. And this will be made possible with an increasingly powerful new set of tools—from attachments that can diagnose an ear infection or track heart rhythms to an app that can monitor mental health—can reduce our use of doctors, cut costs, speed up the pace of care and give more power to patients. We have the ability to do more powerful things with them. They’re really approaching, in many cases surpassing, the ability of the human mind.
An Economist article analyses that the emerging demand for health care looks unlikely to be met by doctors in the way the past century’s did. It reasons that the number of doctors will never be enough if we continue to treat the 21st century’s problems with a 20th-century approach to health care. Doctors are set to become much less central to health care. It also refers to case where doctors in New York used robotic instruments remotely to remove the gall bladder of a woman in Strasbourg. Robots allow doctors to be more precise, as well as more omnipresent, making incisions more neatly than human hands can.
Daniel Kraft, faculty chair for the Medicine and Exponential Medicine programme at Singularity University in his Ted Talk visualises AI (Artificial Intelligence) physicians in the near future, applying cloud based information to make decisions and diagnostics at a level never done in the past. He points out that even today, one doesn’t need to go to the physician in many cases. Only for about 20% of actual visits do doctors have to lay hands on the patient. We’re now in the era of virtual visits – from sort of the Skype-type visits to a very complex telepresence system for health developed by Cisco.
Our perspective
Machines powered by more efficient, cheaper, more accurate diagnosis, extensive analytics on the fly and Artificial Medical Intelligence’, etc. have been predicted to replace 80 % of the demands on doctors’ time. Vinod Khosla, a renowned venture capitalist, referred to common medical practice as being akin to voodoo, saying “healthcare is like witchcraft and just based on tradition” rather than data driven, as he believes it should be. And this he said in an auditorium filled with practicing doctors, challenging them to disagree with him – a challenge that was met with silence.
This could be even sooner than expected as we see IBM’s most popular robot Watson giving guidance on lung cancer at a major cancer research centre. Watson uses natural language capabilities, hypothesis generation, and evidence-based learning to support medical professionals as they make decisions.
Surprisingly, this takeover by machines might be even welcomed by all of us because of two reasons. First, only 20 % of the knowledge physicians use to make diagnosis and treatment decisions today is evidence based resulting in one in five incorrect or incomplete diagnose and nearly 1.5 million medication errors are made in the US every year. So a machine helping in complex decision making will be welcomed.
Second, we already need so many more doctors than we have. In the US, shortage of up to 91,500 physicians is predicted by 2020. This number is low as compared to what the rest of the world may need, especially in Africa which has 25% of the disease burden, and only 1.3% of the health workers.
Robot doctors need not be better than humans, they just need to be better than the human doctors they replace. Indeed, the entire gamut of ‘social services’ such as medicine, education, community services, community health, senior citizen support etc. will significantly gain in reach and quality due to new-age machine capabilities.
Yes, there are careers in these domains but it won’t be anything like what it is! The positive side of being a doctor in the decades ahead – more time for family and holidays, earn more by ‘managing more patients’, lesser legal risks, more flexibility in work timings, lesser travel. On the flip side, intuitive demands to become far more complex and critical (with extensive analytics by software taking care of the obvious and analysable data) and better doctors will become ‘bigger’ at the cost of not-so-well-endowed doctors.
Gazing through the crystal ball
- Medicine will become a truly global profession – a global perspective and deeper knowledge of numerous communities will be the driver of change. Human body is the most global machine and it’s no surprise that medicine will be the first global profession. Leading doctors will be working globally and that league will be open to all doctors to enter (of course, few will reach there due to the multi-disciplinarity of global reach).
- Medicine will be highly digital and technologically advanced – a technical bent will be required among doctors. Extensive use of software tools will be an integral part of the practice and professional growth.
- The ‘cerebral content’ in the job will be much higher and one will have to be a great self-learner. ‘High end’ diagnosis work will increase; for instance, within this decade medical softwares will diagnose and recommend best-fit medicines for most routine needs and only in a fraction of such cases would doctors intervention be necessary to override the ‘artificial doctor’.
- Experience will not necessarily help doctors automatically grow in their profession. They’ll be competing with artificial doctors who will have far too much gain in experience every second (because softwares will access diagnostic and medicinal data from across the world).
- Smart and intelligent para meds will also do very well as medicinal records and recommendations will be concurrently viewable and monitorable by fully qualified doctors.
WHO estimates a shortage of 4.3 million doctors & nurses on this planet, and over 1 billion people live with no access to a doctor, hospital or clinic. Technology will definitely help to enhance healthcare access, however the future will still be rosy for doctors and healthcare professional who apart from medical education verse themselves with skills to harness advances in healthcare technology. Some of the bright career paths for healthcare practitioners will be as follows:
- General practitioners adept with medical technology providing counsel to hundreds of patients through telemedicine and remote care at fractional costs. Doctors will also need to be more compassionate in their practice and interaction to distinguish themselves from machines and sought by patients who are weak, vulnerable and frightened and hence need empathy and hope.
- In the present healthcare system, there is no profit in preventing people getting sick. The more sick we are, the more job security a doctor has. Advancing technology will allow business models to evolve towards preventive healthcare and medical practitioners who will bridle this opportunity will prosper.
- The ‘upstream’ doctors – physicians whose work will include not only to prescribe a clinical remedy but to tackle sickness at its source will be required in future. The doctors of tomorrow will leverage emerging technologies, build partnerships with the patients and the communities, draw on skills and approaches outside medicine and lead and participate in teams of healthcare professionals and community based partners. These doctors will need multidisciplinary knowledge and will require to be qualified not only in medicine but also in social and environmental determinants of health.
- Presently, Complementary and alternative medicine practices lack the strong scientific evidence to confirm their safety and effectiveness for mass adoption. This will change in future with technology aiding to test all proposed treatments objectively. Hence, medical professionals skilled in integrative medicine making use of all appropriate therapeutic approaches (backed by evidence) to achieve optimal health and healing will thrive.
