“I’m a medical student. Which specialty should I choose and what skills will a future doctor need?” “I’m in radiology. Looking at the recent advancements in medical technology, was it a wise choice or should I train myself in something different, too?”
These are the types of questions I most frequently receive after my keynote speeches. While all should be aware of their own physical and intellectual capabilities, here are a few pieces of advice on which skills to concentrate on based on the current and future trends in healthcare.
The most significant trends in healthcare
Artificial intelligence, wearable sensors, virtual reality, medical robots, social media and the like – in a couple of years, disruptive technologies will completely change the way patients and doctors think and act about healthcare. We are at the dawn of digital health.
A cultural transformation of how disruptive technologies that provide digital and objective data accessible to both caregivers and patients leads to an equal level of doctor-patient relationship with shared decision-making and the democratisation of care.
The essential shifts and trends are already prevalent in the definition.
(1) Access to medical data and better care
Unlike before, digital technologies, social media, wearables, and trackers provide medical data and knowledge to many more stakeholders in healthcare beyond doctors. That means the walls of the isolated ivory tower of medicine are crumbling, enabling better access to medical data and through that, better access to care.
(2) A shift in the patient-doctor relationship
At the same time, the status of medical professionals, first of all, doctors, as the sole repositories of medical knowledge ceases to exist as we know it. As patients have access to online medical information sources, patient communities on social media, wearables and health sensors providing medical data, they could present more questions and more knowledge related to their own health. The asymmetrical doctor-patient relationship placing responsibility and hope solely in the hands of the physician will shift towards a more equitable partnership. The patient might assume a more “mature” position, while the doctor might become a guide in the jungle of digital health instead of being a declaratory reference point.
(3) Physicians are teaming up with technology
Doctors have been aided by technology for centuries, however, in most cases, this only meant auxiliary tools and their impact was rather negligible. However, with the emergence of the industrial revolution in the 18th-19th century, more and more medical instruments appeared and their gravity in healing increased. Currently, and in the future more than ever, physicians should team up with technology to provide their best performance and the most efficient care to their patients. Isn’t it fascinating how the medical community is arriving at the digital stethoscope through its analogue counterpart – starting from a wooden tube used first in 19th-century France?
(4) The value of empathy, creativity and problem-solving will soar
As technology provides more and more responses to numerous medical questions that were answered by medical professionals before, personal patient-doctor communication will become less frequent and more valuable. The need for human contact and empathy will be more critical than ever in our technologised environment. Also, neither artificial intelligence nor virtual reality or health trackers will be able to solve complex cases, so in general, creativity and problem solving will become skills to nurture and look for in the future generation of medical professionals.
How will medical specialties change due to the technological revolution?
As the landscape of medicine is as diverse as the metabolic composition of the human body, technological change affects the various medical specialties differently. While it is impossible to predict accurately to what extent the individual clinical areas will be influenced by technology, we have certain “strong guesses” about the ones most and least impacted. Fields using easily repeatable and computerisable tasks, such as administrative duties or the prescription of medicines, could expect shifts.
Areas where natural language processing and computer vision, the fastest growing fields of artificial narrow intelligence (ANI) could be applied, are better to prepare for the coming transformation; and the domain where the novelties of precision medicine could be introduced, will all be prone to change.
Diagnostics, radiology or primary care top the list
The illustration shows that medical specialities that rely heavily on medical imaging and laboratories, will be significantly influenced by the digital health revolution including radiology, pathology – and other non-diagnostic fields, such as nephrology, rheumatology, haematology and dermatology.
In the case of radiology, numerous signs point in the direction that the use of artificial intelligence will prove to be revolutionary. The close cooperation of A.I. and radiology in clinical practice is nigh. The FDA approved the first cloud-based deep learning algorithm for cardiac imaging developed by Arterys already in 2017. According to some estimations, within 2-3 years we’ll have many machine learning algorithms in active clinical pilot testing and approved use. That’s why many radiologists got the idea that A.I. might replace radiologists soon. Yet, I believe instead that A.I. will augment their jobs and free them from plenty of monotonous and repetitive tasks.
Regarding primary care, technology can help “manage” overcrowded waiting rooms. Wearable sensors and devices that stream data to a GP’s smartphone, notifying them whenever vital signs of patients are acting up will provide doctors with all the necessary data for delivering care. Thus, chronic patients will not have to travel to their physician only for regular check-ups. Moreover, chatbots and smartphone-based digital assistants could diagnose minor conditions and offer simple treatment advice remotely in the future, which would spare people in rural communities or hard-to-reach places the trip to the doctor. Chatbots could even become the first line of primary care – meaning that patients might only get a doctor’s appointment if the A.I.-based chatbot could not offer sufficient medical help.
In the field of oncology, A.I., nanotechnology, and genetics all could bring the change we all wish to see. Oncologists already customise therapies based on patients’ genetic backgrounds and their tumours’ molecular makeup. Cheaper genome sequencing and measuring blood biomarkers are speeding up this process.
Smart algorithms are designed to offer personalised treatments for any cancer type or patient faster than any traditional healthcare service. Moreover, artificial intelligence-based predictive algorithms could help epidemiologists better fight disease outbreaks, gene therapies, and digital contact lenses make eye care more efficient, virtual reality, exoskeletons or exercising machines could shorten rehabilitation time or alleviate pain.
Psychiatry, emergency medicine or nursing will be supported
Certain medical fields will most likely experience a different effect of digital health technologies. All specialities where human factors such as empathy and caring attention are the core of the practice, high levels of creativity and problem solving, and quick decision-making abilities will override any technological solution in the majority of cases.
In the case of psychiatry and psychology, therapists are irreplaceable – and it will remain so for at least as long as robots don’t learn how to mimic empathy. This doesn’t mean however that digital health will not knock on the door. Digital therapeutics (DTx) solutions are getting ripe, and there are already a number of FDA-approved, prescription-only solutions increasing the efficiency of therapies fighting addictions or depression.
Of course, conversations about the psyche are usually complicated and stuffed with insightful non-verbal communication, which machines are unable to catch or explain. It is highly unlikely that algorithms or robots could react to patients’ sentences in the right way, which occurrence truly needs the ability to pay attention and empathise with the other in a profoundly human manner.
Based on the same argumentation, nursing cannot be based on technological grounds, but it will be assisted in many ways for physical, repetitive and non-essential tasks. The blood-drawing robots have arrived, and others are on their way to help nurses lift and dress patients. A.I. solutions will aid them to filter out irrelevant noise and prevent alert fatigue.
Regarding emergency medicine, portable diagnostic devices or medical drones can significantly reduce the time until a patient receives a proper diagnosis or specific treatment, but the ambulance crew will always remain indispensable on the spot. They will however receive immense support from a number of A.I. (like this one detecting pulmonary embolism) and machine learning algorithms (like this one detecting intracranial haemorrhage using information collected before patients reach the hospital).
The ambulance crew will always make the decisions about the patient’s state, provide the initial diagnosis and an amount of care which guarantees the individual will arrive in the hospital. No smart algorithm or robot can ever replace that, but their capabilities will be enhanced by technology.
What skills to have in the digital health era?
As the technological revolution has a different impact on every medical specialty, the necessary skill-set for successfully picking up the ins and outs of a healthcare field also widely varies. However, we could discern some general skills and principles based on the requirements of the digital age and technologically boosted healthcare. If someone acquires this knowledge, the waves of innovations could bring new tools and gadgets for them, but the grounds will be as firm as a rock in the face of any transformation.
1) Patient design
For decades, the medical community has left the single most important player out of every major decision regarding healthcare: the patient. Medical students and doctors should understand and embrace the idea once and for all that the patient is at the centre of our universe. This is the basis of both modern and digital healthcare. No matter whether it’s about developing a new drug, designing a new treatment path or shaping the blueprint of a brand new hospital building.
Patients should be included on the advisory board of big pharma companies, of hospitals, they should get a say in organising medical events, and a lot more. Patient design should be the mantra of medical students, but physicians should also remind themselves from time to time – as it is still not as axiomatic as tourists around La Tour Eiffel.
2) Become friends with advanced technologies and start with a tracker
Credibility is crucial. As a doctor, you cannot say to a patient to live a healthier life if you smoke like a chimney and sit like a couch potato at home in front of the TV with snacks every night. Medical students, physicians, nurses and other medical professionals should try health apps, fitness trackers, and wearables themselves to be able to recommend those to patients. This way they won’t have an aversion to technology in the long run – and they might have a more entrepreneurial spirit when it comes to mixed reality, robots or smart algorithm-based diagnostic devices.
Besides, if they familiarise themselves with fitness and health technology, it will also get a lot easier to understand their patients’ concerns and questions about them, while they will realise that the recommendations are not just the results of pharmaceutical or other medical company sales representatives’ successful sales tactics.
3) Be at home in the digital jungle
The necessity for digital literacy is as evident as the fact that you get sunburnt when lying in the sun for too long. It should be so for medical students, professors, and physicians, too. Knowing how to search for, find and assess information; assessing the quality of medical websites; knowing how to work with empowered patients should all be essential skills for physicians of the near future.
Besides being omnipresent, the digital terrain has another persistent characteristic: it changes constantly. Thus, not only should everyone familiarise themselves with the basics of the digital world, but also the tech-savvy should pay attention to changes and keep pace with the rapid development of the online space.
4) Focus on soft skills such as empathy, creativity and paying attention
Parallel to the advancement of technologies, the need for paying attention and turning to patients with compassion will become a more and more valuable asset. On the one hand, chatbots, smart algorithms, and other technological solutions might cut back on many situations where human contact is necessary. On the other hand, disruptive and cheap solutions could create a setting where visiting a human doctor might be more expensive than technology.
The shift towards jobs requiring soft skills already shows in the numbers. The US Bureau of Labor Statistics predicts that while positions for doctors and surgeons will rise by 3 percent by 2030, the number of registered nurses will increase triple-fold, by 9 percent.
5) Get used to being in a network
Tech pioneer Vinton Cerf, often referred to as “the father of the Internet,” said that the online platform “is not merely a technology but a new way of cooperating, sharing, and caring”. That presumes to exit an isolated state and to become permanently part of a vivid network.
I experienced the power of crowdsourcing already at the dawn of social media. In 2011, I used Twitter to solve a complicated case. Social media can be incredibly useful not only for solving medical mysteries but also in the case of rare diseases. The National Institute of Health, America’s medical agency, recognises 7,000 rare illnesses – defining as rare the ones that affect fewer than 200,000 people each. A general practitioner cannot possibly remember all of these. That’s where for example CrowdMed comes in. Patients submit their cases to the site, and medical students, retired doctors, nurses or even laypeople offer their potential diagnoses. The ones whose medical assessment was accurate for the case receive some reward: a few dollars and a rise in the system’s ranking.
Beyond CrowdMed, many doctors use Twitter for asking around about cases. Using hashtags like #quickcase, many posts unidentifiable pictures about patients specifying their problems and/or possible solutions and ask for help to move forward. If you have a specific medical question and you pose it understandably, you could even get dozens of possible solutions.
6) Question everything. I’ll tell you why!
The engine of innovation is critical thinking – questioning traditional methods and seemingly natural processes, which have been in place for a long time. The ability to judge results, procedures or claims from different angles and in various contexts will prove to be essential. In the era of A.I, humans will soon have a hard time keeping up with smart algorithms, questioning their decisions or treatment recommendations.
On top of that, interconnectedness and access to quality medical information by the patient communities can provide knowledge pockets that find their way to the literature years later. It is a new factor, also worth considering.
To keep your brain fit, medical students and doctors should use cognitive games such as the Elevate and Lumosity apps to improve comprehension, focus, and self-confidence. Moreover, for mastering the art of sound judgment, I recommend you to visit Good Judgement, where you can gratify your passion towards predicting the future and thinking about various likelihoods of events.
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