STEPHEN BAXTER
Will high-tech hospitals force doctors out of a job?
SEVENTY YEARS AGO, in June 1945, campaigning was underway in a general election that would elect the first postwar British government. Arguably, the Attlee government’s most significant achievement was the establishment of the National Health Service, which was implemented across the UK by 1948. Much cherished and politically divisive, the NHS certainly delivered a revolution in healthcare across Britain.
Today, the march of technology promises – or threatens – to deliver a revolution just as profound. One recent eye-catching example was the kicking of the first ball in Brazil’s 2014 World Cup by a paraplegic man in a mind-controlled exoskeletal suit. Such devices hold out great hope for many patients. Work on external prosthetics is underway at Tokyo’s University of Science, while a team at the Kentucky Spinal Cord Injury Research Center at the University of Louisville is making progress in crucial human-machine communication interfaces.
But other medical advances are perhaps more significant, even if they are less spectacular. Thanks to the ubiquity of smart, interconnected devices, the boundary between patient and medical practitioner is dissolving. New technology enables monitoring and diagnostics in the home and even in the body. Already we have apps for smartphones and watches to monitor vital signs like pulse rate and calorie counts. And as foreseen by Greg Bear in his 1990 novel Queen Of Angels, a smart lavatory could make good diagnostic use of the large volumes of stool and urine samples you deposit into it every day...
Technology is invading hospitals too, with such innovations as smart bandages with sensors 3D-printed onto the cloth, capable of monitoring vital signs. Meanwhile, an interesting computer program developed at Oxford University is capable of diagnosing some genetic disorders from digital images of faces: an example was a tentative diagnosis of Marfan syndrome, associated with large facial features, based on a photograph of Abraham Lincoln.
Customised medicine, with treatment based on your personal profile, is in development. A potential problem with this might be a widening health gap between rich and poor – your wealth might some day significantly influence your longevity, if it determines the health options you can afford.
But where is your doctor in all this? Just as automation destroyed jobs on the shop floors and factories, and is now replacing office workers like travel agents and secretaries, even highly skilled medical professions are under threat. Radiologists, for example, are being replaced by patternrecognition software. As for GPs, who needs Star Trek’s Dr McCoy when you can have your own tricorder? As reported in May’s BBC Focus, the X Prize Foundation has sponsored a $10m competition to develop a handheld device capable of diagnosing 16 specified medical conditions.
There is even a pioneering robot surgical system called Da Vinci, from Silicon Valley firm Intuitive Surgical. But would you trust a robot surgeon? While ‘simple’ conditions may be treated by smart systems, the human body remains a messy and mysterious object. Anybody who has had experience of a complex medical condition will know how significant a role human judgment plays in most treatments, which is a quality we may still be some time away from automating. And surely patients will always need the human empathy of a good nurse.
“Radiologists are being replaced by software. And who needs Dr McCoy when you can
have a tricorder?”