Physician and patient, and the future
Will the patient-physician relationship change profoundly in the near future?
Dr. Stephan Rietiker, MD, graduated in medicine from the University of Zurich
In the future, we will increasingly be able to determine for ourselves whether we are sick or healthy.
This technology allows us, so far to a limited degree, albeit ever increasingly and comprehensively, to determine symptoms of a sickness at any time and individually and make an initial basic diagnosis.
Imagine a transatlantic flight during which a passenger suddenly complains of pain in his chest. A portable device, perhaps a smartphone in the future, could be used to obtain a quick ECG reading and analyze the results using algorithms so that the curves no longer need to be read and interpreted by us. Early signs of a heart attack would be identified and the pilot could turn around immediately and land if necessary. Technically, this will be possible very soon.
Now, does this mean that we won’t be needing physicians anymore in the near future? Obviously not. The digital system cannot replace physicians. But it can make their work more efficient and help you as a patient – or as a healthy bystander – to identify symptoms. A physician will always need to be involved when it comes to deciding on or administering treatment. What we offer is diagnostics in a technologically integrated system. However, this is merely a first step toward deciding on and administering treatment, which can only be done by a physician. This also sets us apart from manufacturers of lifestyle gadgets such as Google or Apple.
The shifting understanding of the physician’s role toward a medical services provider
In the future, physicians will be part of an information and data collection system; something that is already a reality in the U.S. The change from formerly eminence- to now evidence-based healthcare will further accelerate considerably. Physicians will no longer be diagnostic gatekeepers , but rather be in charge of verifying diagnoses and ultimately treating their patients. Let’s assume you are suffering from persistent tonsillitis. The app on your smartphone can tell you not only who specializes in this disease, but also who is actually available to see you, whether this physician is accepted by your health insurance and with what hospital he collaborates if surgery is necessary. This means that in such an environment we are no longer speaking merely of diagnosis, but of a global coverage of all the patient’s needs.
The transformation illustrated here cannot be reversed, and it has already progressed considerably in the U.S. But the good old family doctor model should nevertheless not be abolished. I would consider such a development to be disastrous. After all, it’s the physician who continues to have an in-depth idea of his patients’ health, because he has been providing them with care which may even span many years.
Interestingly, we are also seeing a backlash against highly specialized medicine in the U.S. Physicians are again being trained for some hospital positions to play a supervisory role with an overall picture of the patients. However, I fear that the trend points toward the other direction, also because it’s becoming increasingly difficult for general practitioners to find adequate training residency training positions.