I have had this conversation over and over again, so I decided to lay out some arguments here. I am convinced that we are on the brink of a major change in the way medicine is practiced for two reasons. The first, which I will leave for another occasion is the empowerment of the individual through technology and the rise of a medicine centred on maintaining health in contrast with a centred on curing disease – precision preventive medicine. The second, which I will discuss now, is the emergence of AI, sensors and robotics and the changing role of the health professionals, a topic that worries me as we keep training health professionals for a medicine of the past.
AI is outperforming humans in individual clinical decision at a steady pace – in some cases it is still in early days, whereas in others like analysis of medical images it is already an established fact. At the same time, we are building increasingly better robotics, for example able to draw blood consistently from a human arm, able to perform surgeries, etc. There is obviously a lot to improve, but the qualitative leap has been made by technology, it is now a question of steadily improving it to consistently outperform humans. Finally, user-directed sensors and point of care diagnostics are increasing in quality and approaching medical-grade accuracy, reducing the need for a sophisticated infrastructure for diagnostics. These three concur for a radically changed medical practice, that will supersede the emerging paradigms of Medicine 2.0 and Health 3.0 (not sure what to call it: Medicine 4.0 is already taken to mean something different..).
I hear recurrently the argument that we will never accept a non-human medical doctor, that no one wants a robot drawing blood or to discuss one’s emotional needs with a digital psychologist. I would argue here that the Western World is unlikely to lead the adoption of this new medical paradigm, for the simple reason that we are used to having a human-provided medical practice. It seems to me that in the West we will only adopt technologies as long as we have a human smiling or looking appropriately worried. Hence no robot psychologist, disembodied nutritionists, digital general practitioner or any contraptions to touch our body and measure “things” without the intervention of a human overseer. However, there are many parts of the world where
- all the advances of modern medicine have been slow to arrive, where vaccination is lacking, simple access to antibiotics is difficult, where modern medicine is absent or incapable of delivering all its might and power. This includes many parts of what is called the “developing world”. This is the first reason that convinces me that the promise of better health to a population that so direly needs it is enough of a motivation to drive adoption of new tech-based medical care. The need is there.
- Secondly, we have seen this in other areas of technology. Africa is currently leading the way in IoT, for example driving mobile money technology, partly out of necessity due to the lack of pre-existing infrastructure. The willingness is there.
- Thirdly, because younger generations are much more likely to adopt novel approaches, and in the west, particularly in Europe, we are, as is well known, growing older and incapable of replacing the dying population. Younger generations are there.
- The fourth reason is the generalised lack of economic resources serving as a massive incentive for the development of cheaper solutions now, rather than in a distant future, thus a robotic/ai medical care is better now than the training of whole medical establishments in sufficient numbers to serve the whole population in some distant future. And much cheaper. There is a need for cheaper solutions now.
- Finally, the trend for direct to consumer solutions that do not involve depending on “experts” is likely to play a role, and if you think about it, the “developing world” is where most of the consumers will be – an irresistible temptation for anyone trying to create a business that needs to scale. The market is there.
It is worthwhile wondering how we should plan for the future of our health businesses….