Category: Future of Healthcare and Medicine

Cannabis M.D.

Check this out. What you will be led to is the web presence of Jill Becker, M.D.  Trained in Ob/Gyn, Master’s Degree in counseling psychology, ordained Minister, etc.  BUT. Her main claim to fame is that she has extensively studied the use of cannabis used to deal with a large variety of medical problems. She will “work with your care team” to figure out the right cannabis program to cure what ails you. AND. Talk about a practice that is perfect for using telemedicine! She can work with patients nationwide using telemedicine platforms and can also help patients avoid any stigma that might accrue to being seen sitting in her waiting room. 

Bottom Line. Got me to wondering. How many other doctors have figured out this schtick??? Do the Google search and roam around like I did and you will know what I know. LOTS!!! All doing it via telemedicine.

Smart. I can see this specialization filling a real and important need that many (most?) doctors wouldn’t touch with a ten-foot pole!

Digital Therapeutics

Check this out. What you will see is the announcement of the launch of the first FDA-approved video game designed for the treatment of ADHD. Being marketed through, you guessed it, digital media. 

Go to their website and watch the trailer

One wonders how many more videogames will come onto the market, FDA approved, requiring an Rx and costing $100 per month, to compete with this initial offering. Or will this be a monopoly? 

Lots of other questions come to mind. What will the receptivity of healthcare practitioners be for this offering in particular, digital therapies in general? Will parents pony up the $100 a month for three months of initial therapy? How effective will the therapy be? Will parents reup after the initial trial? 

Bottom Line. Don’t you just love it when something genuinely new like this comes along? All the new research avenues that one gets to pursue! 

Industrialized Medicine

Check this out. What you will see is a psychiatrist, who specializes in helping physicians and their organizations deal with “complex personal challenges,” asking his colleagues a question. Are they “healers” or are they “widgets.” According to Dr. Adelman, the trend over the last 50 years toward “industrialized medicine,” where doctors’ workflows are controlled by corporations rather than by their own wills, has caused there to be so much “coming at them” that they are like Ethel and Lucy in the chocolate factory. They just can’t keep up. They become unable to do “their best work.”

A powerful quote from Adelman’s post:

Malaise sets in when you realize that you have become an almost inanimate object.  This is ‘physician burnout,’ which has been conceptualized by some as a form of moral injury visited upon us by industrialized medicine.

Bottom Line. The move away from being a healer and toward being a widget seems inexorable. This is not likely to get better in coming years.

My question? Then what will “worse” look like in years to come???

Too Many Cooks (Docs) In The Kitchen??

Check this out. What you will see is a comment on a very important trend in medicine today. Quite simply, patients used to be treated by their own doctors. Period! Now, due to after- hours “doc in a box” facilities, the growing reliance on Hospitalists for the care of hospitalized patients, the use of NP’s, PA’s, etc., a single patient is often confronted by a plethora of HCP’s. As pointed out in this article, continuity, efficiency and other desirable parameters wind up being significantly reduced by this trend.  

Bottom Line. The truly amazing part here is that the introduction of all of the various HCP types listed above was, in no small part, motivated by the desire to increase efficiency of medical care.  

Once again I say, “Beware of unintended consequences!”

Still Willing To Die At Age 75???

Check this out. A really bothersome and thought-provoking little ditty about the guy pictured above. Ezekiel Emanuel, MD. Brother to Rahm Emanuel, recent two term mayor of Chicago. Head of the Bioethics Department at the University of Pennsylvania, and chief architect of Obamacare. Not an intellectual lightweight.  

“Way back” in 2014, Dr. Emanuel penned a controversial article entitled “Why I Hope To Die at 75.” The URL I am sending you to today provides excerpts from an interview recently conducted with Ezekiel, basically asking him if he still believes what he believed five years ago, and asking if he has any further thoughts on the topic.  

Read this piece and ponder the points being made. Basically, there are two. First, Ezekiel believes that beyond the age of 75, people consume so many scarce healthcare resources that they wind up depriving others, children for example, of appropriate access to care which would be more beneficial to them than it is to the oldsters. Second, and somewhat scarier, is his notion that since even vital people beyond the age of 75 are spending their time “playing” instead of working, their lives are not worth extending anyway.  

No, Dr. Emanuel is not planning on “offing” himself on his 75thbirthday. BUT. He is planning on refusing medications and other treatments specifically designed to prolong his life as of that date, and believes that others reaching the 7.5 decade mark would be well served by doing the same thing.

I gotta tell ya! When I first read the Atlantic article, I was a mere child, aged 66. I had just really hit my senior years, and his article struck me as more of a curiosity than something that I should spend a lot of time pondering. Scroll forward 5 years, and December 5, 2019 will be my 72ndbirthday. Yikes. Only three years left for me in the Emanuel manual, so this time around I gave the doctor’s thinking some serious attention. BUT. I am still enjoying exercising several hours a day and working with Dr. Neale Martin on Habit EngineeringSMas an entirely new paradigm for pharmaceutical marketing and marketing research is some of the best and most important work I have ever done. SO…

Bottom Line. Although I understand where he is coming from, I believe that the variations in vitality, including both activity and productivity, make his theoretical end point of “health span” arbitrary enough to be declared incorrect.  

At least I hope so!

Visits To Primary Care Physicians Are On The Decline

Check this out. What you will see is a report indicating that office visits to PCP’s have dropped significantly over the last several years. So, you think, the patients are showing up to see NP’s and PA’s? Not so fast. This report also indicates that the rise in visits to the non-physician providers, as the chart above demonstrates, accounts for only half of the lost PCP visits. As another surprise, you will also see commentary indicating that any shift from physician to non-physician providers is NOT providing the cost savings that one would anticipate. Bottom Line. While I found these statistics to be interesting, this report left me with three questions.  First, if only half of the PCP shortfall is accounted for by non-physician providers, where the heck did the rest of the visits go?  Second, how can there be no cost savings if visits shift from physicians to non-physicians? Third, what does this trend mean for our businesses?    Inquiring minds want to know!

Flirting With Functional Medicine

Check this out. What you will see is a riff by our old friend The Country Doctor, pictured above, on the topic of functional medicine. In this post, he reveals that he is starting to integrate some of the principles of this discipline into his practice. But there’s more! Embedded in this post is a 20-minute video that clearly explains the underlying principles and practices of functional medicine. Watch it. There you will learn that rather than treating symptoms and diseases, FM deals with protecting and energizing the body’s systems and mechanisms that, when abused, lead to the negative sequelae that physicians spend their time treating. A lot of this makes a whole bunch of sense. Bottom Line. Think about it. Functional medicine brings with it a whole different modus operandi for physicians and patients alike. No longer is the doctor’s day divided into 15-minute modules of patients presenting symptoms and doctors prescribing therapies. The doctor/patient interaction becomes much more consultative. Educational. Holistic. And yes, time consuming. As a result, functional medicine will be, for the foreseeable future, much more likely to be the stuff of concierge practices and less likely to be found in production line clinics. What new business opportunities, and challenges, would such a shift in focus bring to our businesses? Like I said … Think about it!

Faith Popcorn—Then And Now

Faith Popcorn. Futurist. I have been following her work for years. In the good old days, she was predicting trends in such books as Clicking, pictured above. Example. She predicted “cocooning,” a movement which saw American families increasingly choose to remain safe at home together rather than venture out. So what? Burgeoning sales of home-entertainment devices, home theaters, etc. That’s what! Scroll forward. Check this out. What you will see is Faith’s brief slide show on how she sees the future of healthcare morphing. For example, important shifts in demography, like the description of a child as being “gender fluid.” Other important shifts in healthcare delivery, like self-driving clinic pods that bring medical care to your door. Take a few minutes and go through the slide show. I think you will find it thought provoking and potentially eyebrow raising. Bottom Line. Having gone through this slide show several times now, I am left to wonder as to why I don’t see more of this “futurist stuff” going on in our vertical. Presentations at our conferences? Articles in MM&M and other trade publications? I am left with two possible interpretations. The first one is that even though there is probably no vertical that will be morphing as fundamentally and rapidly as healthcare, we are not paying the attention to predicting the future that we should be. That would be a shame, since pundits like Popcorn have the tools to help us to make these predictions with rigor and accuracy. The other interpretation is that Popcorn and her colleagues are working with select, forward-thinking companies in our vertical, but doing so quietly to gain a competitive advantage. Amazon? J.P. Morgan? Berkshire Hathaway? I’m guessing option B. So what? Those companies that are not looking out a decade or two into the future better get started in doing so, or they will be left way behind as the future unfolds. That’s what!

Is She Too Cute To be A “Good Doctor?”

Sandra Scott SimonsMaybe! Check this out. According to Dr. Sandra Simons, the ER physician pictured above, doctors attempting to practice medicine against the metric of patient satisfaction might just lead to this conclusion. Seems that young female physicians are going so far as to put their hair up in buns and wear fake glasses to “sell” patients on their being good enough to “satisfy” patient needs. “Sell,” in fact, is the damning word here. This article is replete with examples of physicians having to spend their time on convincing patients that they are satisfied, rather than on practicing good medicine. In a clever metaphor, she asks rhetorically what would happen if we ran schools based on student satisfaction. All day recess, no homework or tests and peperoni pizza for lunch every day is what would happen. Patient satisfaction determining how “good” medicine is? How about a cheeseburger on the way to the OR, or getting me out of the ER faster rather than appropriately treated? Patients, she rationally notes, are just that.  Patients. They are not “customers.” Bottom Line. Study Dr. Simons’ article carefully. You will see that she tees off, I believe quite appropriately, on both patient satisfaction and quick medicine as dangerous, and in fact ridiculous, metrics of “good medicine.”   Will 2018 see the powers that be come to recognize this absurdity and do something about it? Stay tuned!

Merger Mania

CVS Yeah, I know. By the time this blog gets posted, we will all have read a gazillion articles about the CVS/Aetna deal. BUT. I found this one to be especially insightful. I like the candor of the article. The point it makes that the exact nature of the synergy that this union will produce is still unclear. And that the damned thing might fail, either by being blocked by regulatory forces or by failing to realize the anticipated synergies. Bottom Line. That having been said, the article acknowledges what I think we all believe, i.e., this is going to work. SO. We all better start thinking about what “work” will look like, and the impact that will have on the delivery of health care, healthcare marketing and marketing research, and virtually everything else that touches us as professionals in our vertical.