Medical Encounters of the Third Kind

The practice of Medicine is designed around the physician-patient encounter, one in which the patient sits across the table from the physician or lies in a hospital bed or an operating table. That was the only type of medical encounter possible until not long ago. That´s how physicians have been trained to think and work, that´s the scenario implicit in medical textbooks and early clinical protocols.

Medical encounters of a different kind are already possible today. Among them:

-         Real-time “virtual” consultations (online, 3G)

-         Asynchronous consultations (email, formularies…)

-         Encounters with  non-physician providers (where the de-skilling of certain procedures or interventions  makes it possible)

-         Access to (or proactive delivery of) customized, relevant information on prevention, risk, wellbeing… without the direct involvement of any provider

-         Point of care diagnostic tools that allow the self-monitoring of chronic diseases by patients

Medicine has indeed incorporated great advancements in diagnostic and therapeutic technologies in the past few decades. But their translation into significant improvements in efficacy and efficiency (plus in other relevant parameters such as accessibility, convenience, etc) is constrained by the lack of innovation in delivery formats. In some sense, new technologies are funnelled through old structures and mindsets and thus are not fully exploited.

In a not too distant future, a large share of medical care could actually be delivered without the patient and physician having to be in the same room. In the process, healthcare will be transformed. An opportunity to do things differently… but also an opportunity to do entirely new things. Healthcare will no longer be a strictly local business (which will have great competitive implications). It will no longer be episodic, but rather continuous or at least far more frequent. That diabetic patient will no longer be “seen” only every 6 to 12 months…

This is not a futuristic tale, the technology is here. The most important barrier to the growth of these alternative encounters (to their gaining an increasing share of healthcare services) is not one of technical or “medical” viability but rather an issue of commercial viability (reimbursement schemes are anchored in the old world).

For all this to become mainstream, we need to rewrite Medicine. Its textbooks and protocols. We need innovative health insurance products and new delivery models that capitalize on the many opportunities to provide non-presential medical services.