Hundreds of miles away, our patient has just used his personal Tricorder (yes, like the ones in Star Trek) for the daily evaluation of his “systems.” Just like on the U.S.S. Enterprise, the tricorder quickly compares the patient’s biometric information against his personal records, as well as a global database, to identify anomalies and risks to wellness. Culling through millions of algorithms in the blink of an eye, the artificial intelligence (AI) program determines a series of diagnoses and sets about corrective treatment. All from a remote location, the AI accesses the patient’s embedded “system assists” — dispensing insulin, adjusting cardiac rate, and monitoring digestion through a tiny camera in his stomach. His electronic health record now reports “all systems are go.”
Admittedly, the reality of this scenario is still a little ways off—but it’s not as far-fetched as you might think. Today, some complex lab results that used to take 24 hours to process now take as little as 12 minutes. Wearable and ingestible sensors send constant information on vitals, and Big Data repositories reinforce research and clinical treatments. If that’s not futuristic enough: doctors—aided by robots — have successfully performed surgery on patients thousands of miles away. And finally, a group of researchers, aptly named Final Frontier Medical Devices, were awarded a $2.5 million prize for creating a working tricorder prototype that can diagnose 13 medical conditions without assistance from a physician.
With the line between fact and (science) fiction blurring more every day, how can we prepare today’s med students for tomorrow’s healthcare? We can start by exploring the ways that technology can improve their practice, by doubling down on the importance of flexibility and “soft” skills, and finally, by continuing to shift the culture of medicine from “sick care” to preventive care.
Infusing AI into healthcare remains a controversial issue, namely for reasons of security, privacy, and accuracy. But the case for AI is strong. As Ali Parsa, Founder and CEO of UK-based Babylon, said in a recent Wired article on healthcare innovators, “No physicist today solves complex problems without the help of artificial intelligence, yet our medical professionals try to analyze one of the most complex entities on the planet—human bodies — without its help, in a ten-minute consultation.”
The next class of med students couldn’t be more prepared for the challenges of integrating these disruptive modes of technology into their practice. As digital natives, they’ve come to accept continual innovative change and to expect instant communication. They’re also used to making informed decisions based on their own research. This new class of students paired with AI will make a formidable analytical and problem-solving team.
There are, of course, limits to this pairing. Flexibility and sound human judgment— critical traits of medicine in any era — will be as important as ever as we learn the boundaries of trusting technology.
A Deep-dive Into Specialty Pharma
A specialty drug is a class of prescription medications used to treat complex, chronic or rare medical conditions. Although this classification was originally intended to define the treatment of rare, also termed “orphan” diseases, affecting fewer than 200,000 people in the US, more recently, specialty drugs have emerged as the cornerstone of treatment for chronic and complex diseases such as cancer, autoimmune conditions, diabetes, hepatitis C, and HIV/AIDS.
“The 21st century requires a different kind of physician because the knowledge base is now close to infinite, and learning facts in medical school is no longer a useful approach to training,” says Gordon Strewler, MD, professor of medicine at UC San Francisco in a recent article. “We have to teach future physicians how to think and we need to push them to the limits of current knowledge so they will recognize the limits and learn not just how to live, but how to thrive in a world filled with ambiguity.”
We must also consider the subjective side. Technology can adjust our patient’s biomedical function, genomics can personalize his cancer drugs for best outcomes, but how do we identify the environmental, economic and psycho-social contributing factors to his biomedical status? More importantly, how do we pro-actively mitigate those factors to optimize health and wellness? And which definition of wellness should be used? Society’s? His physician’s? His family’s?
The Association of American Medical Colleges has identified 15 core competencies for future students and graduating physicians. Six are science and reasoning based, while the other nine relate to communication, teamwork, service, and ethics. This focus on interpersonal development is a clear statement that tomorrow’s physician is expected to draw on physiologic science knowledge while also being a successful collaborator with colleagues, diverse healthcare disciplines, and, ultimately, patients.
To meet this challenge, medical schools around the country are implementing new curriculums that include team-based learning, social medicine, humanities, and global population science. Additionally, they are incorporating immersive experiential learning to ensure students integrate knowledge with behaviors. Structured to support the development of self-reflection and assessment, the goal is competencies — not grades — and a lifelong pursuit of learning that is critical for today’s rapidity of change.
The object of these new approaches is two-fold: to continue pushing medicine forward and to make health care just that — caring for the health of people. Symptomatic, as opposed to preventive, treatment is hugely expensive in both time and money for patients, hospitals, and the economy. The next generation of medical students must continue to carry the torch in the push for wellness. This could mean looping in a larger network of preventive health care providers to ensure patients’ have the care they need to maintain all the areas — physical, mental, and spiritual — of their health throughout their life.
Let’s check back in on our patient who’s just had his biometrics adjusted. Turns out he only had ice cream for dinner tonight. Why, you ask? Because he felt like it! Tomorrow’s medical student will need the interpersonal skills to understand our patient, the network to pair him with a host of other health providers, and the know-how to evaluate data sets and new technologies that help determine the best road to our patient’s wellness. Implemented properly, these skills might just prevent our patient from needing a “systems reset” again.
