Let’s start by taking the following as givens:
• As the growing elderly population floods the healthcare system, it will introduce a strain that our current methods of care will not be able to properly handle
• The desire for patient empowerment will continue to shift greater care responsibilities away from traditional providers and towards the individual who will manage themselves
• Medical technologies will aid this empowerment by commoditizing historically complex and expensive medical procedures into common tasks performed by smartphone accessories
• Medical diagnosis and treatment knowledge will become universally and freely available and, more importantly, translated into humanistic, accessible language to be used by all
The convergence of these trends and more will lead us to, in my opinion, two inevitabilities. First will be a healthcare renaissance. By placing the knowledge, technology, and responsibility for care in the hands of everyday people, we will upset thousands of years of reliance upon medical professionals. We will change the basic roles in the healthcare system out of both desire and necessity. We will reserve doctors as consultants for only the most complex and challenging medical conditions. We will give greater authority to nurses and technicians to carry out increasingly common and routine medical functions. We will create machines capable of automating a number of medical procedures such as surgery and basic checkups. And at the center of all of this will sit you and I: everyday individuals who will essentially act as our own GPs and be the centerpiece of monitoring, managing, and making decisions about our own health.
The second inevitability will be the absolute clusterfuck that ensues around giving every Tom, Dick, and Harry their own stethoscope and telling them “you’re in charge.” While the health community will undoubtedly do their best and take every precaution to transfer this responsibility seamlessly and effectively, if history has anything to say about how changes to our health system roll out, we can anticipate at least a few hiccups. Misinformation, wrongful self-experimentation, abuse of medications and treatments, and medical obsessions are only a few of the challenges that await this “utopian”, fully-empowered health system. And while guys like me will do our best to help design a system that is completely foolproof, I am reminded of the Douglas Adams quote: “A common mistake that people make when trying to design something completely foolproof is to underestimate the ingenuity of complete fools.”
Bigger, Stronger, Faster, Deader
Naturally, we can expect many people to abuse these newfound tools and responsibilities. In true human fashion, it’s never enough to simply be healthy, and one could easily imagine the use of devices and medications to be experimented with in an attempt to augment and enhance our bodies. However, when is enough, enough? In the pursuit of human perfection, how far will we push the baseline of health and our understanding of normalcy? We’re already starting to see these types of enhancements in experiments with night vision eyes, superior prosthetic legs, and even cosmetic surgeries. Where do we draw the line?
Some people may end up being successful with these modifications and could find ways of using medical technologies to push their abilities and health beyond the status quo. Others, largely bereft of the experience or intelligence to understand the consequences of their actions, will fail miserably, making themselves even sicker, possibly disabled, or, while simultaneously upping the competition in the annual Darwin awards, dead.
Black Market Care
Even with self-administered care available, limitations will obviously be put on the availability and dispensing of medicines or treatments. But fear not; where there’s a will, there’s a black market. In order to support the abuses outlined above, the underground economy will undoubtedly find a way to provide access to medications and technologies for your every whim and fancy. Even when considering legal access to medical resources, this reality simply highlights the need for new distribution models, which will emerge through whatever channels, above or below the board, it can.
Beyond simply enabling off-label use and abuse, the creation of such a market could have a host of knock-on effects present in any criminal activity – theft, murder, bribery, and all sorts of other fun for the whole family. In short, the medical black market of the future may make today’s drug trade look like a game of Monopoly. Perhaps some in the legal community also envision this future and are taking steps, such as the life imprisonment of Silk Road founder, Ross Ulbricht, to send a clear message reminding us that government is the only one who’s allowed to dabble in narcotics.
We all have one of those friends who believes they’re always sick; whenever some new outbreak or condition is announced on the news, they’re convinced they have it. They got E. coli from their burger. They got an STD from a toilet seat. That rash on their arm is necrotizing fasciitis. Imagine what these types of people will do when you give them the knowledge, technology, and responsibility for diagnosing themselves. Suddenly, the blissful ignorance that so many of us living under the care of medical professionals enjoy will be snatched from our medically-apathetic selves. And for those who constantly fret and worry their bodies, we will show them the spiral through which they might decent into a medical information-fuelled madness.
While some hypochondriacs may actually benefit from the immediacy of self-monitoring, others will fall into this spiral of health and body obsession. They will collect every piece of data available on their body and scream bloody murder each time the slightest deviation surfaces in one of their health metrics. And worse than the massive time sink and anxiety source for these individuals, think of everyone around them (who is also a sort of doctor), who will have to listen and be consulted every time their heart skips a beat or shit comes out a slight off-shade of brown.
Our celebrity-obsessed society may encounter a few issues in this empowered future as well. Initially, traditional celebrities – athletes, actors, models, etc. – will become templates for the rest of us to model our lives after. Instead of simply buying an athlete’s workout routine or a model’s diet cookbook, they’ll now be able to package and sell the full set of their health data to compare against and use as an unnatural target point for our own bodies. However, over time, we will enable an entirely new form of celebrity whose rise to fame will not be through athletic prowess or artistic talent, but simply the rarity of medical perfection. Individuals will be revered simply for having a numerically superior health makeup, and I shudder to envision the dangers and insanity around coveting better, yet unattainable for most, medical metrics.
Our obsession with such meaningless and impossible numbers will drive us to take unnatural actions in the name of better data. Drugs could be developed to artificially adjust the blood’s chemical composition. Surgeries could be performed to unnaturally raise or lower heart rate. We will lose sight of the importance of health and go to dangerous lengths to optimize our numeric health, potentially at the expense of our actual health.
The scenarios presented are not intended to be prophecies of doom and gloom, but instead speculations on how our health system could evolve given the emerging shifts we see around us and our natural curiosity and human inclination to mess with everything we touch. If stakeholders in the health system are aware of the changing social and technological landscapes and are smart about their designs, these types of scenarios can likely be avoided. The last thing we need is for one of the greatest shifts in healthcare since the Hippocratic Oath to be mired by the irresponsible follies of man. However, we do love our follies.
I hope I’m wrong… I truly do. However, if anyone disagrees strongly, I’m open to bets.