"Dammit Jim, I'm a Doctor!"
The Promise of Digital Health
(There will always be a role for a good doctor!)
Earlier this week I attended yet another Health Tech conference. The event was filled with frenetic energy, as technologists and entrepreneurs and patients and pundits gathered to find the next app or software or piece of tech that is going to solve the healthcare crisis. This conference was by no means alone in this endeavor. In the SF Bay Area alone, there seems to be a new conference, meeting, hackat hon, incubator starting, accelerator launching at least every week. Each year, conferences seem to find their own buzzword or simply fall in line with the trending national buzzword. I’ve often left these conferences, thinking that it could easily be converted into “buzzword - the drinking game” - a shot for every utterance of said word. A few years ago it was “interoperability”, last year it seemed to be “block-chain”. Please don’t misread what I am saying, although I am sure at least one of you will. I am not picking on this event; I think that they put on a great conference. What I’m saying can just as easily be applied to any of the myriad conferences I’ve attended.
The intention is great! The focus, however, can use some redirection.
Why do I say that? Primarily because…
Technology Can’t Save Healthcare!
Let me clarify at this point that I am neither a Technophile, nor Technophobe - but if I were to lean one way I’m definitely more of a technophile! Tech is simply another tool - and as with any other tool, it really depends on how it is used. But Tech won’t save healthcare, for the same reason that the WWII orphans studied by John Bowlby and Renee Spitz failed to thrive from a lack of human contact; and the same reason that the Harlow’s Rhesus macaques chose the soft cuddly mother over the one with the food. Despite all our technological advancements we haven’t evolved that significantly from the people who first started organizing into settlements, and raising cattle and farming - and certainly less compared to the people that stepped off the first ships landing in the American colonies. We are wired to connect. As Darwin hypothesized it isn’t the strongest, nor the fastest, nor the sharpest-toothed or clawed that survive, but the species most able to adapt. In that arena, we had three huge advantages - our brains, our hands and our ability to work together.
I still remember when I first heard soldiers who’d returned from war, telling me of their buddies dying in battle - who would call out for their mothers. When we are sick or injured we want to be cared for by someone that we can trust and know cares for us. Studies have borne out that patients do much better if they truly believe that their physician cares about them, regardless of the treatment itself. There may be a hundred reasons that that is so. It could be because the placebo effect kicks in, convincing them that this treatment will work. Regardless, it works.
“I will remember that there is art to medicine as well as science, and that warmth, sympathy, and understanding may outweigh the surgeon's knife or the chemist's drug.”
- Modern Hippocratic Oath
As we move forward, defining what the future of medicine will be, it is really important that we establish a vision of what we want that to look like. And, just like I tell my patients, we can always course correct and redefine what that vision is. Not having a clear vision, we run the risk of trying to chase down every possibility, and like a dog chasing its tail, we spend all our energy getting nowhere (but tired) in the process. As Steve Jobs said ““Deciding what not to do is as important as deciding what to do.”
My personal vision for the future of medicine is one that inspired the name of this blog! Futurist and humanist, Gene Roddenberry created the Star Trek universe, and along with that the character we know as Bones, Dr. Leonard H. McCoy. As a young child watching the show I saw him assess and treat patients, mostly Capt. James Tiberius Kirk; it was always him connected to the patient. His tech never got in the way, rather it truly facilitated a better, more informed, more competent interaction between the doctor and (in this case) his patient. Moving forward as we evaluate health technology ideas, that should be the question we ask. Does this truly augment that relationship, or simply distract from it?