In Pursuit of A Greater Tomorrow
Medicine is failing to use one of it’s the most underutilized assets — the next generation of doctors. A group of people typically found spending their evenings grueling away in a lab, volunteering at a hospital, or shadowing a doctor. To understand why we’re so unique, you have to first understand the nature of the problems in healthcare and why doctors, specifically, are not in an ideal position to solve some of them.
The Problems
It’s clear that the state of medicine is heading in the right direction, just look at the recent FDA approval of Novartis’s Gene Therapy treatment. But as we get better and better at developing treatments, collecting data, and improving survival — we seem to have created a healthcare system with a wide range of gaps and inconsistencies. The patient experience is fundamentally flawed and a lot of the infrastructure seems to match technology from the early 2000s.
Healthcare feels chaotic, challenging, and confusing. It surprises me that we are allowed to have incredible experiences while booking hotel rooms or finding a place to eat, but we cannot have those experiences in the hospital, while getting our own medical records, or in trying to have an unprecedented, personalized, and complete understanding of our health. On top of all this, healthcare is quite expensive. In the year 2000 health care consumed 13% of the U.S. GDP, and now it is around 18%; this rate of growth is surely unsustainable.
Researchers have already done a phenomenal job in highlighting a lot of the problems revolving around our inefficient healthcare system, but the subsequent lot of solutions seem to be too costly and disconnected from the patient’s interests. However, if we actively begin to involve the future generation of doctors to solve healthcare’s problems through means of mass experimentation, Healthcare 2.0 is just a couple years out.
Why Doctors Can’t Solve It All?
We tend to make mental models of how we think the world works. As famous historian Yuval Noah Harari puts it,
“Scientists generally agree that no theory is 100 percent correct. Thus, the real test of knowledge is not truth, but utility.”
In science we build our mental models as ways to make sense of the world and rank them based on utility. Of course, this is all based on the current data available.
The irony here is that the more educated a person gets in one concentration or the more firm belief one has on their mental model, the more it becomes part of an intrinsic belief, and disrupting it can be similar to attacking a person’s ego. Sometimes, this is quite the pitfall.
I was working as a researcher within a Liquid Biopsy lab far before companies like Grail and Freenome raised hundreds of millions for their liquid biopsy blood tests. You would not believe how many educated oncologists that I talked too firmly told me — liquid biopsy will not be available to the masses for at least the next 10 years because of all the kinks left to be worked out.
Since then, companies have leveraged the power of big data and machine learning to bridge those kinks and we’re at a point where we’ll be seeing the first direct-to-consumer blood tests within the next couple years. The point here is that the solution to a problem as wide as healthcare, cannot be tackled by the mental models formed by doctors alone — it requires outside help from all sorts of disciplines and people.
Another example of archaic mental models comes from Silicon Valley. Before Google, internet search was a lost cause for most investors because it was costly and plagued by a horrible user experience. Investors were so firmly held on this belief, that they literally went out of their way to make sure that they didn’t have to hear a pitch from Sergey or Larry. Retrospectively looking at, this was obviously one of the greatest missed investment opportunities of the decade.
Simply because the world is so dynamic and unpredictable, by attempting to make it predictable through our mental models — we automatically discredit certain ideas. This is why, a lot of disruptive innovation tends to come from the outsiders, those that do not have any preconceived models on how they think a system works.
Doctor’s are no exception. Doctor’s create their own mental models and assumptions through their clinical teachings and day-to-day experiences, which can sometimes may be a subset of the “truth”. This has ultimately allowed doctors to conform within the current system, therefore possibly limiting the breath of innovative ideas that they can spurn.
On top of this, doctor’s are just too busy. From medical billing to catering to their patient cohorts, a doctor’s time is incredibly valuable, and expecting doctors to sacrifice that to propose new workflows in healthcare isn’t the best use of their time.
Being dictated by the status quo, limited by time constraints, and focused on the current well-being of their existing patients, doctors are not-so-perfect candidates to propose and experiment with new healthcare solutions. But they are quite accommodating to those who do, often serving as prominent advisors and thought leaders.
The Next Generation
I truly believe that those best poised to fix healthcare are our current pre-meds and medical students, the side-liners of medicine. The comprehensive access within the epicenter of medicine that we have and the fact that we have yet to internalize some of the traditions, beliefs, and workflows that doctors take for granted makes us perfect candidates to propose novel ideas to change the field.
Those that are observant and social in their everyday interactions — every document, doctor, patient — can piece together a puzzle in which every entity has a story and workflow that intermingles in various ways. What you will come to realize is that there are pieces missing that can be solved for.
It is safe to infer that technology will slowly be able to store, regurgitate, and analyze all the necessary data for doctors thus augmenting a lot of what a doctor does and freeing them to care in more holistic means. The only true commodity will be that of analytical intuition, creativity, leadership, and the personal touch. Which is why it surprises me why medical school admissions continue to heavily rely on objective metrics (GPA, MCAT) over life experiences, cognitive diversity, and projects — seems fairly counterintuitive to the direction that medicine is headed in.
Medicine needs to tap into some of its most hard-working and incredible thinkers even before they become doctors. Rather than solely using metrics (GPA, MCAT score), should the field incorporative novel and innovative ways to create, engage, and support student led-initiatives, healthcare will surely proper.
The first step for future doctors is obviously identifying a problem they feel strongly about, and this is often a personal journey, but there are certain macro-tailwinds that can help act as lens through which one can propose and create ideas.
Over the next 3 articles, I will discuss three tailwinds in great detail to help illustrate not only how much is there to fix, but also why the next decade will shape and transform healthcare.
1. The Role of Big Data
2. Value-Based Care: Putting Patients First
3. Rise of Digital Therapeutics
The sheer amount of experimenting with new models, solutions, and approaches will serve to not only be a fruitful experience but if done prolifically enough, will surely spur some lasting change. Even if a majority of solutions fail, simply being aware and able to spot and discuss problems, as well as stay up to date with these trends is enough. It goes without saying that the more aware the next generation of doctors and medical employees are, the clearer it is to envision and collectively work towards a greater healthcare experience.
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