It’s not unusual to hear groups of doctors speak of being ambushed by “Dr Google”. Doctors are frequently faced with patients who have used Google to self-diagnose serious illnesses when, in fact, they have relatively minor and treatable conditions.
No matter how time-consuming this type of doctor-patient interaction may be for the doctor, internet-driven healthcare is here to stay. In fact the entire technological revolution is rapidly changing the face of modern medicine.
In his book The Creative Destruction of Medicine: How the Digital Revolution Will Create Better Health Care, Dr Eric Topol argues that technology can democratise medical systems in a groundbreaking way. Topol, who is chief academic officer of Scripps Health, a nonprofit healthcare system in California, predicts the end of one-size-fits-all medicine. Instead patients can look forward to personalised solutions for their health problems, he believes.
Informed consumers will control their own healthcare based on genomic information and real-time data obtained wirelessly through nanosensors, he says.
“The one I’m most excited about is the embedded nanosensor. You have to put it in the bloodstream, and [it] will communicate with your cellphone. And that embedded nanosensor can be used to pick up, for example, the first cancer cell that shows up in the bloodstream, which would promote the earliest possible detection of cancer.”
Technology aside, how will the democratisation of medicine affect the doctor- patient relationship?
“It will have a marked effect of changing the relationship [from one] based on information asymmetry to a partnership for which the predominant role of the physician is guidance, experience and wisdom, along with compassion, empathy and communication,” says Topol.
There is an argument that healthcare systems as they are presently structured cannot accommodate change on this scale. Dr Bertalan Mesko, in his recently published book The Guide to the Future of Medicine, says that ever-improving technologies "threaten to obscure the human touch, the doctor-patient relationship and the very delivery of healthcare".
The doctor and medical futurist warns that these enormous technological changes could “wash away” the medical system as we know it and leave in its place a purely technology-based service without personal interaction.
“Such a complicated system should not be washed away. Rather it should be consciously and purposefully redesigned piece by piece,” Mesko argues.
There is also a role for doctors of the future in helping patients learn to use social media meaningfully. Doctors’ skills may change from simply knowing answers to being skilled at finding answers. Communication skills will focus more on listening than on telling patients what to do, and on facilitating a safe navigation through the maze of information available.
Do people trust doctors less now than, say, 10 or 20 years ago? “While my first inclination is to say yes, the evidence supports the fact that patients will ultimately come back to their doctors for the most important conversations,” says Dr Bryan Vartabedian, a healthcare blogger and assistant professor of paediatrics at Baylor College of Medicine, in Texas.
And what will happen to the broad doctor-patient dynamic as power shifts more to the patient? Vartabedian says this move has already begun. “It started with access to information. It will evolve shortly to personal data from biosensors. The physician will emerge as more of a moderator of information than a sage.”
