There are about one million doctors in the U.S. today.
There are 24 hours in a day, I’ve been told. The average physician works for close to nine of those hours. So there are nine million hours available in a day to provide medical care to America’s 325 million people. That’s if a physician is not whittling down those nine hours by taking on tasks not directly related to care, like working out insurance paperwork, and the rest.
That’s all we have to work with. Try as we might to bring the cost of healthcare down, we have a bottleneck, we have to squeeze efficiency out of just those hours. It takes a long time to make a good doctor and there are only so many quality medical schools. Remote care is a great thing, but connecting with a doctor over a distance doesn’t make more time in the physician’s day. Artificial intelligence has tremendous potential, but engineers must take great care before trusting an algorithm to do no harm – and you have to ask yourself if you’re ready to hand your child’s care to a robot. Self-driving cars are still working out the kinks.
To judge whether a policy proposal or technology can make a difference in bringing about more affordable care, I ask myself, does this multiply the power of a physician’s hour? Does it equip a patient to walk out of a doctor’s office and execute the care management plan they’ve established?
Companies from Adherium, Glooko and Klue to Apple Inc. and Google parent Alphabet Inc., are working to better leverage doctors’ time. Adherium is launching a new technology called Hailie to take asthma and chronic obstructive pulmonary disease care management plans – through sensors on an inhaler, connected to a smart device – and make them second nature.
Many of the solutions seem to seek to expand the number of people capable of offering medical care by moving capabilities from MDs to different nurses or medical practitioners with lower educational requirements. Others seek to create computer or robot stand-ins for doctors. While each of these is probably part of the solution, a complete solution will also certainly include two critical, unreplaceable elements: better using the time that trained, skilled (human) doctors are already spending with patients, and truly empowering patients and caregivers to be active participants in treatment.
Researchers are daily stretching the boundaries of what we can do with medicine. We have fantastic drugs for treating many chronic conditions: whether the condition is asthma, diabetes or COPD. Skilled practitioners already do a good job of diagnosing, prescribing and modifying treatment plans to keep up with individual patients' symptoms, lifestyle and stage of illness. But we have very limited means of stretching a doctor’s day beyond 24 hours.
One we do have is technology that makes it easier for patients to follow doctors’ advice in all the time they aren’t in a doctor’s presence. The state of the art has long been a written log. And while something is better than nothing, we can now use wired tools to supplement peoples’ fallible habits and memories and do so much better. Smart, connected devices like Adherium’s Hailie offer a quantum shift from the pen-and-paper system that has long been the best doctors can offer when a patient leaves the clinic by delivering reminders and recording usage data.
As long as at least half of patients are not following through with taking their medicine as directed once they leave the doctor’s office, the U.S. will continue to spend as much as $300 billion on preventable medical costs. That’s almost three times as much as the country spends on cancer treatment, to remedy the effects of failing to adhere to prescribed treatment. The right technology offers a simple solution which magnifies the abilities of doctors and pharmaceutical researchers to improve patients' health.
K. Cody Patel is CEO of Vitalus Health, a pulmonary disease management and diagnostics company headquartered in Houston.