Medicine in the Face of Technological Challenges
“In this electronic age we see ourselves being translated more and more into the form of information, moving toward the technological extension of consciousness” Marshall McLuhan ( 1911–1980)
It is no secret that technology has recently evolved at breakneck speeds, particularly since the creation and massification of the Internet. Activities such as shopping, music, books, entertainment, education and others have been transformed and will continue to change as a result of this influence. I am sometimes amazed that we, as doctors, doubt or show ingenuity in the face of this reality or that we, perhaps unconsciously, minimize its influence on medicine due to the particularity of our profession.
The presence of technology giants in major health and technology projects is not fortuitous. Apple, Google, IBM, Samsung are all spending millions of dollars in health related initiatives that will completely transform the sector in about 20 years. Projects like Healthkit and ResearchKit by Apple to monitor vitals and change the enrolment in clinical trials, Google’s Calico to battle aging, IBM’s Watson for handling information in the cloud, among many others, have the potential and resources to change the future of our field.
According to author and historian Yuval Noah Harari (Sapiens, Homo Deus) we are at the point where artificial intelligence is already a reality and will shift from a natural selection to an “intelligent design” process. In his book, The Creative Destruction of Medicine, Eric Topol, Head of Translational Medicine at the Scripps Clinic, discusses the convergence of 6 elements in the past 40 years that enable us to talk about a technological revolution in the health care sector: the mobile phone, the personal computer, the Internet, digital appliances, DNA sequencing and social media converge to form our current historical inflexion point.
In fact, this technological evolution and convergence has predicted the coming of another singularity: a state of coexistence between human and artificial intelligence made possible by computers that will be able to auto-improve themselves or redesign themselves, that is expected somewhere between the years 2030 and 2045.
Meanwhile, we live in a moment of the transition in which it is hard to believe in the aforementioned changes, and they evoke images of horror and science fiction movies.
In our workplaces we find that screens prevent us from seeing the patients, that medical records are full of data that hinder care and prevent contact, consultations overburdened by administrative dealings which leave no time for in depth explorations. As a whole, there is an excess of irrelevant information that distracts us from all that is essential: the human touch.
What is true and what is overblown? What does the future of health care look like? The future of medicine and of our specialty?
Marshall McLuhan, a recognized communications theoretician, used to say that every culture develops its own sense of balance in response to the demands of its surroundings. His theory proposes that an individual’s cognition and perception modes are influenced by the culture in which said individual is in, the language he/she speaks and the means of communication to which he/she is exposed. “Every culture, so to speak, offers its constituents tailor made spectacles.” There is an evident change in the language and media we use to convey information, but also knowledge, what’s good and bad, depends on the use we give them. “The media is the message”, said McLuhan.
While us doctors have been known to follow the Hippocratic tradition, embracing the scientific spirit of challenging what we do, and almost revering the support of evidence and the transmission of information in closed circles, the technological dogma, increasingly omnipresent, fosters permanent innovation, the “beta” spirit of trying and then proving and looking at the need for evidence as a technical problem that is surmountable with access to “Big Data”, transmitting information in systems that are predominantly open to the public. A clash of cultures seems inevitable.
Nonetheless, for better or for worse, in one or two generations the world will be very different from that we know. We should think and make necessary adjustments before it is too late and find a point of balance between what is novel and traditional.
A weighted reflection and change in the vision of medical education and of that which we can do in the face of this possible future:
- Foster innovation: It is a rapidly changing world, where the ability to think differently, challenging the establishment and improving on what is being done, not only for the sake of doing it differently, but out of the genuine belief that what is being done can be improved upon. The ability to challenge the status quo will be a necessity.
- Acknowledging the value of informal information: Formal communications through journals and conferences will not be the only way to transmit or validate scientific knowledge. Scientific information can and will be distributed through more massive media, not just to a reduced group of peers, but to the general public, which will increasingly demand more precise knowledge and the justifications for those studies. In fact, there are already studies that show that social networks are already the main source of scientific information on the Internet, above Wikipedia or digital information media sources, and a preferred information source for our patients.
- Adjusting the teaching of Medicine to the new environment: The jobs that will prevail in the future will be associated to the ability to solve problems. Everything mechanical, repetitive or related to memorization tends to be obsolete in a world where we do not need to possess all of the information, but rather know where to find it. We must develop analytical thought early on, introduce contact with patients early on in the career, foster individual learning and recognize the temporality of new knowledge by stimulating the learning of knew competencies throughout life.
- Improving our digital skills: We must concern ourselves with understanding digital tendencies in order to better communicate with our patients and the public in general, but also with our families. McLuhan also stated “We can do as we wish with new media, except ignore them.” It is impossible to understand the world in which we immerse ourselves without understanding its languages and symbols.
- Rethinking professional practice: To improve our specialty, we should think about the long term future and visualize all of the upcoming changes, analyzing scenarios that allow us to better define what it is we can and want to do.
We can all achieve something from our work and influence spheres.
At PANLAR we want to advance our specialty and trace a balanced future, where tradition and science are combined with new media and ways of learning and working. In this connection, we have included innovation in the Development Plan and have created a Prize, which is currently in its second edition. We have also requested initiatives that take these considerations into account for PANLAR events. We want to be an open-minded organization.
Continuing to believe in our singularity as a defense against these changes, failing to understand or minimizing the technological development process we are currently on could be a regrettable mistake for our trade and specialty, considering the evidence. PANLAR has taken concrete actions to start to close this gap. Time is of the essence.
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Published in PANLAR originally June 2017
