Medicine in the 21st Century: Thoughts of a Visionary (or Revolutionary?)

“The Next 30 Years of Medicine”

By Beverly Kotsanis, CEO of the Kotsanis Institute

Medicine and Societal Trends

Medicine of the future will be a blend of high tech innovation and ancient wisdom. It will be personalized, spiritual and holistic. Consumers want solutions customized to their way of life and their belief systems. The current conventional medical system is very much drug-based and surgery based and consumers are increasingly becoming disenchanted by the high cost and lack of results, especially when it comes to chronic conditions.

Societal trends toward individualism also influence healthcare trends. No one wants cookie cutter solutions. People are less trustful of authority figures (medical practitioners) and want to regain control of how they stay healthy or recover from illness. Having mapped the human genome, it now becomes more realistic to engineer a treatment for a patient based on their unique genetic fingerprint, their cultural upbringing and their spiritual beliefs.

We already have the genetic and testing tools to design diets, choose drugs and other treatments based on unique genetic profiles.

While the Internet is already providing a wealth of information and tools for wellness and illness, mainstream medicine is not willingly changing to accommodate patients’ appetites for a blending of old and new. Establishment naysayers cite lack of scientific proof that these new methods work. In reality there is plenty of scientific evidence; (and I am about to make a bold prediction) the “scientific method” will soon be marginalized due to the fact that it really can only be used to test substances in the drug world.

Think about it. Surgery is not tested this way because it is impossible to double blind the surgeon and patient. Why then would you test mind-body medicine acupuncture or any other non-drug therapy in this manner? Body, mind, and spirit will never be fully understood. This is the mystique of medicine which makes it part science, part art and part religion (“I believe I can help you.”) The principles that apply to biochemistry are different that the principles that apply to the invisible world of biophysics or metaphysics. And you can’t apply the rule book of one discipline to the other.

Cost as a factor in consumer choice

As we begin to see the higher cost and increased restrictiveness of the Affordable Care Act (ACA also affectionately known as Obamacare), consumers are realizing there is no such thing as free healthcare. The law, which was promulgated as a panacea for repairing our health system only addresses cost and not quality, access or choice. It is clear now that for the majority of Americans the cost of insurance has gone way up.

The rollout of the ACA was seriously flawed, way too expensive and may actually cause the demise of the current system within five years. One thing is for sure. It will get much worse before it gets better.

So what would replace the current system? Part of this answer depends on whether our elected officials will do the right thing (repeal ACA) or keep cultivating relationships with the medical–industrial complex. We predict for the near future (five to ten years) we will still have a multi-tiered delivery system that will contain the following:

Convenience, Technology and Wireless Monitoring

• Your Internet-connected mobile device will join you to practitioners that can answer your questions. Services are already available that offer this. This will be a pay-as-you-go fee-based service or a subscription concept. It will be convenient but will not provide the continuity of care or relationship you would have with your personal health practitioner.
• We expect to see more digitized monitoring of bodily functions and online recordkeeping that allows multiple practitioners to access your information. This is already possible but not widespread. It will become more popular with younger people who are more tech savvy. Older people will be more concerned with privacy of health information and may shy away from cloud-stored records.
• There is already nanotechnology that can examine you from the inside and transmit information and images to remote servers where the data is analyzed for diagnosis or monitoring. This will be more prevalent as the cost of technology goes down with more people adopting the service.
• New high tech procedures are already allowing organs to be grown from autologous cells. And they can actually “print” organs on 3-D printers. These state-of-the art procedures will remain high-priced and available to only a few until the procedures become more commonplace and more practitioners are trained to do them.
• High-priced, high-tech procedures will not be widely available to the average person after the ACA has been fully rolled out.

Blending Conventional with Complementary and Alternative Medicine (CAM)

• A handful of medical doctors, pharmacists, nurse practitioners and physician’s assistants are already blending drug medicine, nutrition, acupuncture, naturopathy, oxidative medicine, botanicals, essential oils, spiritual/mind-body, energy medicine and other techniques. This trend will continue because people believe in approaching problems from more than one angle.
• There will be more consumers interested in prevention of illness as health care costs increase. “An ounce of prevention is worth a pound of cure” has never been more relevant than it is now. People will take matters into their own hands thus eating organic foods, doing yoga, massage and meditation for stress reduction and eating fewer processed, chemical-laden foods.
• Younger consumers will shy away from drug medicine in future generations in favor of less expensive natural, nutrition and exercise-based solutions.
• People will turn away from traditional grocery stores and grow their own food using technologically advanced methods such as hydroponic gardening.

Consumers Broaden their Horizons – Cost and Quality

• More consumers, especially those with serious chronic illness will begin to become disenchanted with conventional medicine and look for better service and more effective treatment. They will realize that they are able to buy direct from certain health care providers, not use insurance (due to high deductibles) and negotiate fees directly with the professionals they use. Not surprisingly, baby boomers will lead this trend.
• When negotiating directly, the price of all services in the marketplace will go down.
• When the taxes and premiums consumers pay become unsustainable, they will likely drop the insurance. At this point, all the practitioners whose scope of practice has been increased will have a higher likelihood of getting some of these consumers to come to them.
• Some consumers will leave the country and settle in countries with lower cost of living and better medical care. This is already happening but the trend will continue and the number of people moving will increase.
• There will be more practitioners that do not accept insurance because it is too costly to wait for payment and hire additional staff to fight insurance companies for a reduced reimbursement.
• Hospitals will also lose some control of patients as consumers become more sophisticated. Well-educated customers will demand more respect, shorter wait times and better pricing.
• Practitioners of every stripe will begin educating current and prospective clients in their respective disciplines. By so doing they will be connecting with their customers and engaging them in the health conversation. These relationships will be bonding, long-lasting and mutually beneficial.

Law and Politics

• Laws, while necessary for an orderly society, will remain archaic in the near term because politicians in bed with special interest groups create obstacles to progress. For example the FDA whose job it is to “protect” us from unsafe foods and drugs is funded by new drug applications paid for by drug companies. The research on many drugs has been found to be flawed and the FDA takes the word of the drug company that the drugs are safe. Drug companies routinely leave out bad results and only report positive ones.
• As consumers are awakened to the “game” they will demand the changes in laws that protect drug and chemical companies. This is probably five to ten years into the future.
• Increased scope of practice – nurses, physician’s assistants, pharmacists and other licensed practitioners will lobby lawmakers to allow their licensure more latitude in the number and types of services they can provide. After all the population is aging and numbers of consumers are increasing faster than we can educate practitioners.
• When Medicare and the Affordable Care Act become financially unsustainable, the tax laws will create a vehicle for medical practitioners to accept tax credits in lieu of payment for services for select categories of patients.

Conclusion

No one has a crystal ball, but if you look around and keep in touch with news stories and talk to your friends and family you will see that these predictions are clearly in the works. The high voter turnout in the 2014 midterm general election was a clear sign that there is a movement to change the status quo in a big way. We must be careful, though not to throw the baby out with the bathwater. We are guardedly optimistic that things will improve over the next thirty years.

Note: This paper was composed to celebrate Kotsanis Institute’s thirty years in business. Anyone who is familiar with the Kotsanis Institute will know that we are actually doing 90% of everything discussed above. If you really want to know what the future holds in store, just follow us on Facebook and visit our web site often. We have led the way for over thirty years and plan to continue at least thirty more.

“Whatever you can do or dream you can, begin it. Boldness has genius, power and magic in it!” ~Goethe