Living in Atlanta and working within the healthcare delivery innovation community, the mounting Ebola outbreak taught us all how quickly the “global” can become local.
For a healthcare system threatened by infectious disease, complex chronic illness, environmental and population management issues, the outbreak also reinforces how new technologies are advancing patient and caregiver safety, prevention, patient monitoring, diagnosis and even treatment.
The answer, through non-contact medicine, is literally in the airwaves.
Researchers at Stanford are pursuing the combined use of laser and carbon nanotubes to provide a more detailed view of blood flow in the brain – down to single capillaries – to increase the understanding of cerebral-vascular disease beyond the imaging provided by CT scan or MRI.
At the turn of the 20th century, we built a healthcare system on responding to acute, curative, episodic issues. This system saw the eradication of many diseases and the advent of vaccinations and new treatments. The model was truly developed to be a “sickcare system,” which was what we needed at the time, and saw huge successes.
Fast forward 100 years and Americans are sicker than ever — but with different illnesses. What’s more, there is finally a national consensus that our healthcare system is broken. 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.
Sadly, patients are not the only ones suffering. The status quo is breeding a morale crisis among our nation’s doctors. If you asked one of the many thousands of medical students who are just beginning their fall semester why they chose medicine, many of them would give you confused, anxious responses about the field they are entering. This does not bode well for the health of future generations.
Last Spring, we met at TEDMED, an annual “grand gathering” in Washington, DC where forward thinkers from all sectors explore the promise of technology and the potential of human achievement as it pertains to health and medicine. Here, we presented our respective positions. One of us, Ali, argued that new technologies will actively change our health behavior. Another, Sunny, argued that we needed systems thinking in public health, focusing on the causes of the causes. Yet another, Jacob, argued for stopping the “imaginectomies” and fostering creativity in medical training by rethinking selection criteria and curricula for entrance to medical school.
Our family debates a lot of things over our dinner table – the best Looney Toon character, politics, whether or not (and where or when) something is appropriate… For many of these topics, there are no right answers and no wrong answers – just a whole lot of discussion and opinions.
A few months ago, on the heels of the Health 2.0 conference, a small group of us gathered in a San Francisco kitchen for one of the most powerful experiences most of us had ever had around a dinner table.
I’ll admit that the question on the face of it struck me as a bit absurd, especially when juxtaposed with the term “tomorrow’s doctor.”
Tomorrow’s doctor needs to be doing a much better job of dealing with today’s medical challenges, because they will all be still here tomorrow. (Duh!) And the day after tomorrow.
(As for the 21st century in general, given the speed at which things are changing around us, seems hard to predict what we’ll be doing by 2050. I think it’s likely that we’ll still end up needing to take care of elderly people with physical and cognitive limitations but I sincerely hope medication management won’t still be a big problem. That I do expect technology to solve.)
After looking at the related Huffington Post piece, however, I realized that this trio really seems to be thinking about how medical education should be changed and improved. In which case, I kind of think they should change their organization’s name to “Next Decade’s Doctor,” but I can see how that perhaps might not sound catchy enough.
Last week I found my usually-diverse Twitter feed had coalesced into a single hashtag, the trolley buses chugging through the streets of Washington, D.C. were sporting bold logos on their sides, and all around the city people were wearing giant nametags bearing their name, face, and three things they liked to talk about. There was no mistaking it: TEDMED was in town.
For the world of health care, TEDMED was the only party at which to see and be seen. The thousand or so delegates had been specifically “curated” to encapsulate the epitome of health care innovation. For 3.5 days they basked in cutting-edge, quirky talks by people “shaping and creating the future of health and medicine,” punctuated by lavish dinners and parties, TEDMED-themed M&Ms, and morning runs, as sanctioned by the Cookie Monster (one of the celebrity speakers at this extravaganza). Meanwhile, the rest of the medical world followed the #TEDMED hashtag on Twitter or soaked up the inspiration in real time at one of TEDMED’s mostly academic simulcast venues around the U.S.
And as for me? I threw myself into getting invited to the cool kids’ party. Or to be more accurate, the cool, privileged kids’ party. Because as well as being accepted on merit, attending TEDMED in person costs an eye-watering $4,950. A wealth of sponsors paid for 200 people to attend on scholarships (and for the Simulcasts), but by the time I’d realized this and persuaded them of my innovative brilliance, they’d already allocated their funds and I was consigned to their priority waiting list. But at the last minute, delightfully, my persistence and anticipation were rewarded with a pass for the Thursday night party and the final Friday morning session.
What does it take to get into medical school today?
High MCAT scores. Pre-requisites galore, coupled with a stellar GPA. Research experience. Clinical experience. Volunteering.
It has become a series of check-boxes, many going through the process gripe. Worse, it’s an exercise in conformity.
Last week at TEDMED, Dr. Jacob Scott shone the spotlight on this system as a root cause of the lack of creativity among people going into medicine.
“You can’t take any risks, or you won’t get in [to medical school] – you won’t get into the club,” he told the audience. But, he continued, that means weeding out creativity. Future doctors are being trained to “memorize certainty,” rather than think imaginatively.
Having gone through the admissions process recently, I could relate to many of Dr. Scott’s sentiments. It’s true: preparing to get into medical school does little to encourage risk-taking. Admission criteria are rigid. And you know if you don’t do what they ask, there is no shortage of others who will.
Want to become a doctor? You can’t slip up, or you’ll fall behind. You can’t rock the boat, or you won’t get admitted.
This critique is not unique to medical education. Scott’s talk reminded me of a speech by former Yale English professor William Deresiewicz to the 2009 plebe class of the United States Military Academy at West Point. Skeptical of modern benchmarks of success, Deresiewicz told the young cadets:
“It’s an endless series of hoops that you have to jump through [to get into college], starting from way back… What I saw around me were great kids who had been trained to be world-class hoop jumpers. Any goal you set them, they could achieve. Any test you gave them, they could pass with flying colors…. I had no doubt that they would continue to jump through hoops and ace tests and go on to Harvard Business School, or Michigan Law School, or Johns Hopkins Medical School, or Goldman Sachs, or McKinsey consulting, or whatever. And this approach would indeed take them far in life.”
Last year Priceline founder Jay Walker bought TEDMED –a conference that licenses the TED style and brand but is separately owned from its famous cousin. While there was some fun controversy about the sale, Walker made two key decisions. First he moved the conference from San Diego to Washington D.C. to try to get it more central to the health policy debate, and second he initiated a set of 50 Great Challenges from which the community voted a top 20. These are things like tackling the obesity crisis, getting transparency in medical research, training next generation of leaders and more.
Much of the fun and high production value entertainment from previous years stayed, but there was a new sense of urgency in the air concerning making changes from a top down and bottom up level in the way policy works for science and technology. There was rather less information technology than in years past and more emphasis on things like training of physicians, food policy, and basic science.
Like TED there’s a strong sense of celebrity at TEDMED with entrepreneurs like Walker and buddy AOL founder Steve Case on hand, mixing with newscaster Katie Couric and volleyball pro Gabby Reece. There’s also an interesting (and we hear not cheap) sponsorship model with the exhibit hall being more about zones for discussion rather than tradeshow demos. We like Philips sleep discussion and Booz Allen Hamilton’s discussion area.
Over the exhilarating four days this past week, we all fell in love a little bit — with the city, the Center, the meeting, the ideas, and one another. The city was Washington, DC, a touch past its cherry-blossom blush; the meeting was, of course, TEDMED. The ideas were of about honoring our health, environment, food, and about making health and healthcare efficient and kind for all.
I fell in love with dreamers. Though their dreams were varied, their paths to fulfilling them all converged into the same stream. Like a trip down the Amazon that the biggest dreamer of all, Jay Walker, the curator and the force behind the meeting used as a metaphor for TEDMED 2012, they accepted their tortuous and demanding journeys and, much to our delight and benefit, made a stop at the Kennedy Center. And although I will only mention a few, many others will stay with and inspire me for the months to come until TEDMED 2013.
I fell in love with Bryan Stevenson, who spoke about his grandmother and identity and justice.
It’s the kind of event where you might find yourself (as I did) seated between the Surgeon General and a Nobel Prize winner in Chemistry, with a singer/actor/model type across the table. Yet somehow, everyone finds common ground.
Once again, a who’s who of people descended on San Diego for TEDMED – three days packed with smart, provocative folks discussing how Technology, Entertainment, and Design play out in the healthcare field.
We’ve been attending TEDMED for a few years now, and this one might just be the best we’ve seen yet. From my perspective – an engineer at heart who’s devoted the past twelve years to growing a healthcare technology and communications company – TEDMED boiled down to this: the challenge of managing a range of increasingly complex systems, the need for collaboration, and a clear call to action to effect change.
We’re not kidding when we talk about complexity. A few highlights: Dean Kamen (one of my former bosses and current mentors) of Deka Research & Development and David Agus of the University of Southern California made their respective calls for a more responsive regulatory environment in the face of more complex and sophisticated medical breakthroughs, as well as an approach for documenting the social cost of not approving them. Eric Schadt of Mount Sinai School of Medicine described the dizzying complexity of genetics the way an engineer might model a network – think of a GPS for your DNA – helping even those (like me) who can’t grasp the genetic system understand how it works and how personalized medicines interact with it.