Mike Magee, MD, the author of Health Politics: Power, Populism and Health (Spencer Books, 2005), says, “Just as General Electric revolutionized toasters and refrigerators, and literally did improve the quality of our lives, . . . the same can be done with home health technologies, especially if you leverage them with Wi Max and other wireless technologies.”
Mike Magee, MD, the author of Health Politics: Power, Populism and Health (Spencer Books, 2005), says, “Just as General Electric revolutionized toasters and refrigerators, and literally did improve the quality of our lives, . . . the same can be done with home health technologies, especially if you leverage them with Wi Max and other wireless technologies.”

CV prep

The future of medicine

Table of Contents

Maria Caltrez shuffles slowly up the ramp to her doctor’s office. The 80-year-old determinedly pushes a walker in front of her as her 55 year-old daughter, Ellena, walks beside her.

Screen Shot 2019-03-20 at 11.14.21 PMIt is Maria’s first visit in more than two years. As she enters the office, Matthew Anderson greets them and ushers them to his office. Anderson, the nurse-director of one of several physician-led teams in the office, is ebullient.

“You look terrific!” he says to Maria. “And your heart rate was well within normal range as you walked up the ramp.” Maria smiles broadly.

Maria is one of 50 patients that Anderson’s team monitors 24/7. Maria’s home is wired with motion sensors and diagnostic devices that provide real-time medical data piped directly into Anderson’s computer. Aside from continuously monitoring Maria and his other patients throughout the day, he is alerted if Maria’s vital signs stray outside the pre-set parameters determined by the team.

During the visit, Maria and Ellena discuss Maria’s Lifespan Management Plan with Anderson. He explains some late-breaking research findings and together the three decide to tweak the nutritional component of the plan by increasing certain foods and supplements. Ellena explains to Anderson her mother’s lifelong aversion to one of the foods and together they come up with substitutes. Finally, Anderson reviews with the women Maria’s daily activities schedule.

If Maria forgets to bathe by a certain time, Anderson’s computer will send a video reminder to all television sets in Maria’s condo, actually one of several pre-recorded messages from her daughter, Ellena. Each day, Maria plays a simple video game, which in reality is a sophisticated cognition test, the results of which are transmitted back to Anderson, who is then able to proactively remediate and prescribe social service interventions. The “wristwatch” that Maria wears is actually a diagnostic monitor with a Wi-Max transmitter.

Sound farfetched? Hang on, because the face of medicine
is about to change in ways that few practitioners are able to comprehend. In 20 years, according to many experts, the practice of medicine promises to be radically different from how it is practiced today.

Like our larger society, the social mega-trends of the past few decades have had a significant impact on the practice of medicine. Increased consumerism, the evolution of powerful—some would say dictatorial—payer systems, and rapid advances in medicine itself have each affected medicine down to the practitioner level. But those trends pale in comparison to what is in store for younger physicians. The next 20 to 30 years will see the convergence of more radical social trends and technological changes that will leave no practice of medicine untouched.

Mega-trends

They may disagree on the specifics, but nearly every medical futurist predicts that several potent social trends are now intertwining, and together will eventually transform the tradition-bound practice of medicine in this country. Like the confluence of many small tributaries, this intertwining will strengthen and accelerate the individual changes each trend fosters. Here are three of the most significant social and technological mega-trends that will shape medicine in profound ways and revolutionize its practice.

Aging

Screen Shot 2019-03-20 at 11.14.34 PMThe fastest growing demographic group in the United States is the elderly. “For most people when they talk about aging demographics, they’re talking about numbers of people over 65 or 85,” says Mike Magee, MD, the author of “Health Politics: Power, Populism and Health” (Spencer Books, 2005) and the host of the weekly, Internet-based show “Health Politics with Dr. Mike Magee” (www.HealthPolitics.org). “But, the most important thing about aging is that we are rapidly moving from three-generational families to four-generational families. Nearly 50 percent of all 60-year-olds have a parent still alive. By 2050, it is anticipated that more than 1 million Americans will be over 100 years old. The five-generational family is right around the corner.”

Magee, the director of the Pfizer Medical Humanities Initiative and a senior fellow in the Humanities to the World Medical Association, has studied health-care systems in the United States, United Kingdom, Canada, Germany, South Africa, and Japan. Magee views the American medical system as broken and in need of revolutionary change. That change is around the corner, pushed forward by trends like our aging population.

“From the standpoint of a caregiver,” Magee says, “there is an exponential increase in complexity when moving from managing three-generation complexity to managing four- and five-generation complexity.” Nearly 25 percent of American families now have an informal caregiver in place and 85 percent of those are relatives. The vast majority of these are third-generation women, ages 45 to 65, attempting to manage parents and grandparents on the one hand, and children and grandchildren on the other. There is no financial, organizational, or psychological support for these efforts. Literally, each woman thinks she is doing it for the very first time.

Lacking support, approximately 17 percent of these women resign their jobs and 20 percent are on anti-anxiety or anti-depression medications. If they are charged with caring for patients with dementia at home, nearly 50 percent are clinically depressed. Many of them forego their own regular exams and needed medical care and, as a result, they suffer a higher disease burden than the general population.

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