Call for ideas: What should a 21st-century doctor look like?

In 1900, the leading causes of death in the U.S. were flu, tuberculosis and gastrointestinal infections. Today, they are heart disease, cancer, and chronic respiratory diseases, with stroke and diabetes in the top ten – largely preventable conditions.*

The problem is, our healthcare system, devoted as it is to acute, curative care, still thinks it’s 1900, with disastrous results. As Ali Ansary, Sandeep “Sunny” Kishore and Jacob Scott, all TEDMED 2012 speakers, wrote in The Huffington Post,

“With increasingly tragic consequences, the reactionary medical paradigm has not provided the preventive care or chronic illness management that our culture needs. Healthcare spending currently consumes 17 percent of our GDP and without a radical shift in thinking, this number may grow even higher.”

Change begins with conversation. To that end, the three have launched a movement called Tomorrow’s Doctor, in which they call for ideas on how to reimagine medicine of the future, starting with med ed.  We must re-align priorities, they say, and take advantage of gains already made in technology and public health.

Above all:

“We need to stop the “imaginectomies” and help, collectively, step by step, to make creativity, imagination and compassion the 21st century standards of medical education.”

Read the full article here and visit www.tomorrowsdoctor.org to contribute ideas.

Sources:  Centers for Disease Control and Prevention; New England Journal of Medicine

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5 Comments

  1.  
    Thomas Fowler
    2 years ago

    The role of lecturing should be re-evaluated. Medical school is expensive, and almost anything can be learned with the technologies available today. Subject matter is not always relevant or clinically applicable, and sometimes not all too evidence based. I think practice makes perfect and getting students onto wards and residency should be done sooner.

  2.  
    Shamie Das
    2 years ago

    I completely agree with the authors. The nature of medicine has changed drastically over the past century yet we still conceive of “medicine” as the acute care system to which we have all grown accustomed. Perhaps the challenge lies in misalignment of the public’s perception of healthcare in contrast to the authors’ and my belief that prevention is the key to wellness.

    There are a number of factors that contribute to the propagation of our healthcare system as it is today. We have created an industry geared toward acute care, and those stakeholders have a considerable amount of resources invested in its continuance. The healthcare industry is a jobs program, a technology research and development program, and for some an investment. Doctors of tomorrow are just one piece of the puzzle, albeit an integral piece. I believe that we do have the power and ability to shift the nature of the healthcare economy but not without considerable struggle. But first, we have to win over the public’s trust. Personally, I think that means helping our patients recognize that we are on their side which means dispelling some myths.

    I hate to say it, but the manner in which physicians are compensated (and the uncertainty of the future) drives the the current manner in which we care for patients. It is a widely known fact that preventative services are not compensated as well as those provided in the acute care setting. We need future physicians who are willing to rethink the whole paradigm of how we should be compensated. Compensation – the elephant in the exam room – has become a contentious and avoided topic in the national dialogue. How much should our physicians be paid? I had an elderly patient last week who was thoroughly distrustful of the healthcare system, stating that doctors “are in it for the big bucks!” This was difficult for me, as someone who struggled to get into medical school amassing a considerable amount of debt even before matriculating and then adding nearly $200,000. For me this is a privilege and I have put a considerable amount of sweat, tears, and years for the opportunity to care for my patients’ health. Doctors just want a fair shake for their sacrifices and the ultimate responsibility of putting their patients’ needs above their own – so yes, we do expect to be compensated accordingly, but do not mistake this for the reason why we chose to be healers. We need the public to put their faith in our ability to change the system for the better: to truly get the most benefit for each dollar spent, to help reduce waste, to combat those socioeconomic inequities that lead to poor health choices and outcomes.

    The 21st century doctor is more than a healer, he/she is an activist for the betterment of society.

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