Friday Futures: The End of the Physician
Physicians take a long time to train, and they are expensive to pay. Physicians are extremely expensive repositories of diagnostic and treatment information. They are hard to keep up to date with the newest medical information. And they make bad decisions surprisingly often.
You know what else is a repository of diagnostic and treatment information? A computer or PDA. We don't need to train people to be giant walking databases. We can use actual databases for that. We can use electronic databases and health care providers trained in using them to do the vast majority of the care that physicians used to provide.
We are already seeing a shift to care being provided by physician's assistants, nurse practitioners, and midwives. That shift is going to continue. There are a host of factors in its favor. Moving away from physician care reduces brain drain, because non-physicians are less mobile on the global market. It's cheaper to train and pay non-physicians, and you can educate a nurse, midwife, or community health worker a lot faster than a physician.
Diagnostic algorithms like IMCI can simplify diagnosis and treatment to the point where non-physicians can easily make appropriate decisions. Combine that with powerful handheld computers and mobile health initiatives, and the need for physicians will shrink dramatically. Physicians could end up like specialists in an HMO; you'd only be referred to one if your case couldn't resolved by a nurse or nurse practitioner.
This will improve health care. Every single time we get computers involved, or increase standardization, the quality of care improves. Minimizing the role of deeply fallible, expensive individuals, will be for the better.
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