Let’s start by taking the
following as givens:
•
As the
growing elderly population floods the healthcare system, it will introduce a
strain that our current methods of care will not be able to properly handle
•
The desire
for patient empowerment will continue to shift greater care responsibilities
away from traditional providers and towards the individual who will manage
themselves
•
Medical
technologies will aid this empowerment by commoditizing historically complex
and expensive medical procedures into common tasks performed by smartphone
accessories
•
Medical
diagnosis and treatment knowledge will become universally and freely available
and, more importantly, translated into humanistic, accessible language to be
used by all
The convergence of these trends
and more will lead us to, in my opinion, two inevitabilities. First will be a
healthcare renaissance. By placing the knowledge, technology, and
responsibility for care in the hands of everyday people, we will upset
thousands of years of reliance upon medical professionals. We will change the
basic roles in the healthcare system out of both desire and necessity. We will
reserve doctors as consultants for only the most complex and challenging
medical conditions. We will give greater authority to nurses and technicians to
carry out increasingly common and routine medical functions. We will create
machines capable of automating a number of medical procedures such as surgery
and basic checkups. And at the center of all of this will sit you and I:
everyday individuals who will essentially act as our own GPs and be the
centerpiece of monitoring, managing, and making decisions about our own health.
The second inevitability will be
the absolute clusterfuck that ensues around giving every Tom, Dick, and Harry
their own stethoscope and telling them “you’re in charge.” While the health
community will undoubtedly do their best and take every precaution to transfer
this responsibility seamlessly and effectively, if history has anything to say
about how changes to our health system roll out, we can anticipate at least a
few hiccups. Misinformation, wrongful self-experimentation, abuse of
medications and treatments, and medical obsessions are only a few of the
challenges that await this “utopian”, fully-empowered health system. And while
guys like me will do our best to help design a system that is completely
foolproof, I am reminded of the Douglas Adams quote: “A common mistake that
people make when trying to design something completely foolproof is to
underestimate the ingenuity of complete fools.”
Bigger, Stronger, Faster, Deader
Naturally, we can expect many
people to abuse these newfound tools and responsibilities. In true human
fashion, it’s never enough to simply be healthy, and one could easily imagine
the use of devices and medications to be experimented with in an attempt to
augment and enhance our bodies. However, when is enough, enough? In the pursuit
of human perfection, how far will we push the baseline of health and our
understanding of normalcy? We’re already starting to see these types of enhancements
in experiments with night vision eyes, superior prosthetic legs, and even
cosmetic surgeries. Where do we draw the line?
Some people may end up being
successful with these modifications and could find ways of using medical
technologies to push their abilities and health beyond the status quo. Others,
largely bereft of the experience or intelligence to understand the consequences
of their actions, will fail miserably, making themselves even sicker, possibly
disabled, or, while simultaneously upping the competition in the annual Darwin
awards, dead.
Black Market Care
Even with self-administered care
available, limitations will obviously be put on the availability and dispensing
of medicines or treatments. But fear not; where there’s a will, there’s a black
market. In order to support the abuses outlined above, the underground economy
will undoubtedly find a way to provide access to medications and technologies
for your every whim and fancy. Even when considering legal access to medical
resources, this reality simply highlights the need for new distribution models,
which will emerge through whatever channels, above or below the board, it can.
Beyond simply enabling off-label
use and abuse, the creation of such a market could have a host of knock-on
effects present in any criminal activity – theft, murder, bribery, and all
sorts of other fun for the whole family. In short, the medical black market of
the future may make today’s drug trade look like a game of Monopoly. Perhaps
some in the legal community also envision this future and are taking steps,
such as the life imprisonment of Silk Road founder, Ross Ulbricht, to send a clear
message reminding us that government is the only one who’s allowed to dabble in
narcotics.
Hyper Hypochondriacs
We all have one of those friends who
believes they’re always sick; whenever some new outbreak or condition is
announced on the news, they’re convinced they have it. They got E. coli from
their burger. They got an STD from a toilet seat. That rash on their arm is
necrotizing fasciitis. Imagine what these types of people will do when you give
them the knowledge, technology, and responsibility for diagnosing themselves. Suddenly,
the blissful ignorance that so many of us living under the care of medical
professionals enjoy will be snatched from our medically-apathetic selves. And
for those who constantly fret and worry their bodies, we will show them the
spiral through which they might decent into a medical information-fuelled
madness.
While some hypochondriacs may
actually benefit from the immediacy of self-monitoring, others will fall into
this spiral of health and body obsession. They will collect every piece of data
available on their body and scream bloody murder each time the slightest
deviation surfaces in one of their health metrics. And worse than the massive
time sink and anxiety source for these individuals, think of everyone around them
(who is also a sort of doctor), who will have to listen and be consulted every
time their heart skips a beat or shit comes out a slight off-shade of brown.
Medical Celebrities
Our celebrity-obsessed society may
encounter a few issues in this empowered future as well. Initially, traditional
celebrities – athletes, actors, models, etc. – will become templates for the
rest of us to model our lives after. Instead of simply buying an athlete’s
workout routine or a model’s diet cookbook, they’ll now be able to package and
sell the full set of their health data to compare against and use as an
unnatural target point for our own bodies. However, over time, we will enable
an entirely new form of celebrity whose rise to fame will not be through
athletic prowess or artistic talent, but simply the rarity of medical
perfection. Individuals will be revered simply for having a numerically
superior health makeup, and I shudder to envision the dangers and insanity
around coveting better, yet unattainable for most, medical metrics.
Our obsession with such
meaningless and impossible numbers will drive us to take unnatural actions in
the name of better data. Drugs could be developed to artificially adjust the
blood’s chemical composition. Surgeries could be performed to unnaturally raise
or lower heart rate. We will lose sight of the importance of health and go to
dangerous lengths to optimize our numeric health, potentially at the expense of
our actual health.
In Closing
The
scenarios presented are not intended to be prophecies of doom and gloom, but
instead speculations on how our health system could evolve given the emerging
shifts we see around us and our natural curiosity and human inclination to mess
with everything we touch. If stakeholders in the health system are aware of the
changing social and technological landscapes and are smart about their designs,
these types of scenarios can likely be avoided. The last thing we need is for
one of the greatest shifts in healthcare since the Hippocratic Oath to be mired
by the irresponsible follies of man. However, we do love our follies.
I hope
I’m wrong… I truly do. However, if anyone disagrees strongly, I’m open to
bets.
