Why We Can Never Have Enough Doctors

1 00:00:07,703 - > 00:00:07,964 David: Great. 2 00:00:07,974 - > 00:00:09,704 Okay, that sounds, that sounds interesting. 3 00:00:09,942 - > 00:00:13,433 Let's come back a little bit to the discussion about how technology is 4 00:00:13,433 - > 00:00:17,323 changing the relationships between physicians and patients, and it comes 5 00:00:17,332 - > 00:00:21,504 back to some of your earlier, if not predictions, discussions, uh, about 6 00:00:21,504 - > 00:00:23,384 the empowered patient and so on. 7 00:00:23,803 - > 00:00:28,013 Now, a lot of what's happened in medicine can have some unforeseen circumstances, 8 00:00:28,013 - > 00:00:32,203 at least in the US healthcare system, where what seems to be, wow, that could, 9 00:00:32,293 - > 00:00:36,073 you know, that could reduce cost or improve quality may just be a business 10 00:00:36,073 - > 00:00:40,292 opportunity for someone to insert themselves into the system to add cost 11 00:00:40,292 - > 00:00:44,683 and not necessarily, uh, be looking after either the patient or the physician. 12 00:00:44,944 - > 00:00:48,783 So how do you see, you know, the, uh, the role of, of technology 13 00:00:48,883 - > 00:00:52,093 in the evolving doctor-patient relationship, and are we headed more 14 00:00:52,093 - > 00:00:53,624 in the good direction or a bad one? 15 00:00:54,551 - > 00:00:58,201 I think it's necessarily a good direction because it's, it always - So 16 00:00:58,201 - > 00:01:01,781 we al- when we talk about the role of technologies in healthcare in general, 17 00:01:01,942 - > 00:01:06,462 I always feel like the discussion is about whether we choose to reach out 18 00:01:06,471 - > 00:01:10,231 to this influx or range of advanced technologies because we have a choice. 19 00:01:10,272 - > 00:01:13,680 We can decide not to reach out to them, but that's not the case. 20 00:01:14,052 - > 00:01:17,400 So healthcare today faces a very basic mathematical problem. 21 00:01:18,010 - > 00:01:21,272 About six million healthcare workers are missing today. 22 00:01:21,331 - > 00:01:23,900 The World Health Organization shared that data a few years ago. 23 00:01:24,201 - > 00:01:26,322 And by twenty thirty, ten million healthcare workers 24 00:01:26,322 - > 00:01:27,271 will be missing worldwide. 25 00:01:27,730 - > 00:01:31,652 So we will simply, we, we can conclude that we will never train as many 26 00:01:31,652 - > 00:01:35,941 healthcare professionals as we need, while the number of patients requiring 27 00:01:35,960 - > 00:01:39,412 our constant medical help will keep on rising because, not because we 28 00:01:39,412 - > 00:01:42,441 are getting sicker, but because we're getting better at diagnosing patients 29 00:01:42,451 - > 00:01:45,600 and monitoring them and treating them on the long term, especially 30 00:01:45,632 - > 00:01:47,102 in the case of chronic conditions. 31 00:01:47,441 - > 00:01:51,632 So while healthcare is improving, that number is going to get bigger. 32 00:01:51,632 - > 00:01:54,551 There is a huge niche between how many physicians and, and medical 33 00:01:54,551 - > 00:01:57,721 professionals we can train and how many patients need their help. 34 00:01:58,191 - > 00:02:02,010 That gap cannot be filled in with simple HR tricks. 35 00:02:02,031 - > 00:02:04,381 That gap can only be filled in with advanced technologies. 36 00:02:04,740 - > 00:02:09,040 So just, I wanted to make sure that we talk about this issue from that 37 00:02:09,042 - > 00:02:13,091 perspective, that, of course, it's always better for a patient to be able 38 00:02:13,091 - > 00:02:16,562 to meet a physician in person, and they can build a relationship, you know, 39 00:02:16,562 - > 00:02:18,701 using empathy and compassion and trust. 40 00:02:19,281 - > 00:02:23,860 But that is becoming, gradually becoming a luxury for most of us worldwide. 41 00:02:24,331 - > 00:02:28,942 So instead of that, technology could be the lifesaver, but it's extremely 42 00:02:28,942 - > 00:02:32,991 hard to include that in that process because we are talking about, you 43 00:02:32,991 - > 00:02:35,731 know, patients' lives are at stake, first of all, and then we are talking 44 00:02:35,731 - > 00:02:39,991 about people having relationships with other people, and technology always 45 00:02:39,991 - > 00:02:42,121 has a very complicated role in that. 46 00:02:42,512 - > 00:02:46,360 So that's why, uh, for about one and a half decades, we have been publishing 47 00:02:46,361 - > 00:02:50,872 papers, and I've been trying to u-u-use all my channels in science communication 48 00:02:50,872 - > 00:02:55,691 to talk as much about it as possible, that while we are witnessing an influx 49 00:02:56,401 - > 00:03:00,520 of advanced technologies, at its core, digital health is a, is a cultural con- is 50 00:03:00,520 - > 00:03:02,080 a cultural transformation of healthcare. 51 00:03:02,371 - > 00:03:06,081 Because the way the traditional hierarchy of the doctor-patient 52 00:03:06,092 - > 00:03:09,760 relationship has been transforming into an equal-level partnership, which 53 00:03:09,762 - > 00:03:14,002 is, which is coming with its own rules and, you know, new ways of forming 54 00:03:14,020 - > 00:03:15,581 relationships and building trust. 55 00:03:16,122 - > 00:03:20,320 So all this is happening because of technologies, but the cultural component 56 00:03:20,330 - > 00:03:25,070 of the change is much more impactful than which wearable sensor, smartwatch 57 00:03:25,070 - > 00:03:27,102 or AI algorithm comes out this year. 58 00:03:27,671 - > 00:03:31,451 And the, the sooner I think healthcare systems, governments, business 59 00:03:31,451 - > 00:03:35,692 leaders acknowledge the power of this cultural transformation, I think 60 00:03:35,701 - > 00:03:37,021 the better decisions they can make. 61 00:03:37,021 - > 00:03:40,472 Just to give you a real-life example, I've, I've, I've given countless, 62 00:03:40,542 - > 00:03:45,951 countless, uh, keynotes at medical events to my peers and, um, on 15, 10 63 00:03:45,951 - > 00:03:51,320 years ago, I had so many fights, uh, with them and debates about why they 64 00:03:51,322 - > 00:03:56,050 thought that I was talking about AI and digital technologies taking over their 65 00:03:56,050 - > 00:03:59,701 roles and their responsibilities while it couldn't be further from the case. 66 00:04:00,211 - > 00:04:04,722 The fact was that they, that they had fears and these physicians rejected 67 00:04:04,722 - > 00:04:07,931 the use of advanced technologies, not because they thought that based 68 00:04:07,931 - > 00:04:11,801 on peer-reviewed studies they chose not to use them, but because they 69 00:04:11,801 - > 00:04:15,051 had primal, uh, feelings about them. 70 00:04:15,051 - > 00:04:18,711 Emotions like having anxiety about using those technologies or 71 00:04:18,711 - > 00:04:23,350 fears about privacy or even fears about being replaced in their very 72 00:04:23,620 - > 00:04:25,471 important doctor-patient relationship. 73 00:04:25,471 - > 00:04:30,331 So in these cases, we cannot just focus on pushing the technologies on 74 00:04:30,331 - > 00:04:34,370 them, but we have to focus on finding out why they reject the technology, 75 00:04:34,382 - > 00:04:37,990 why they have anxiety about that, and then working on those parts 76 00:04:38,021 - > 00:04:42,711 before even discussing any specific technologies in that relationship. 77 00:04:42,711 - > 00:04:47,440 And one of my PhD students, uh, published a study about, uh, all these emotions 78 00:04:47,440 - > 00:04:55,230 from fear through anxiety, uh, of… and even resistance and rejection and how 79 00:04:50,821 - > 00:05:00,321 the use of digital health technologies and AI can create these emotions in 80 00:04:55,230 - > 00:05:00,321 physicians and what we can do about these. 81 00:05:00,331 - > 00:05:05,461 So I think if, if we can focus on the cultural components first, then we get 82 00:05:05,471 - > 00:05:10,050 into a better position of finding out which technologies to include in the 83 00:05:10,211 - > 00:05:14,290 doctor-patient relationship that will hopefully improve it and not diminish it.