Nurses, Not Doctors, Are the Future of Medicine
What's the next frontier after that? Doctors. We just may not need them in the same ways we need them today. In fact, there's a case to be made that nurses -- not doctors -- are the real future of the thing we now call medicine.
This idea came up during the Wall Street Journal's inaugural WSJD Live technology conference, in a conversation I had between Dr. Susan Desmond-Hellmann, who leads the $40 billion Bill and Melinda Gates Foundation, and Sam Altman, who heads the well-known Y Combinator tech incubator in Silicon Valley.
Both Desmond-Hellmann and Altman are exploring ways in which incredible diagnostic and monitoring tools are being developed today. Soon these tools will be sequencing your genome in a matter of minutes, evaluating the "biome" in your gut, and using nanotechnology to spot ailments months, if not years, faster than we do today.
The first and often difficult question for doctors is "What's wrong?." Answering it could largely be an automated process, done via monitoring both inside and outside our bodies. What if you had a "check engine" light for your heart or kidneys?
In theory, we could then plug this information into giant databases that will evaluate our conditions against hundreds of millions, if not billions, of other humans. Eventually, these databases will be able to make treatment suggestions based on this globe-spanning omniscience.
Think for a moment about the most wise, experienced doctor you know. Let's say her wisdom came from treating three new patients a day, every single day, for 40 years. That sample size is 43,800, a mere rounding error when compared to the potential of a database that can make recommendations based on billions of inputs.
The exciting and unsettling thing is this: What we regard today as wisdom may just be a crude tool of evaluation, much in the way our sleepy, distracted, impulsive driving choices will over time be inferior to a car loaded with hundreds of undistracted sensors.
A doctor's second task, "How do I cure what's wrong?" might be less a job of human intuition, and more of a kind of concierge or interpreter to machines. If you wanted to be extreme and uncharitable about it, you'd call it the work of a clerk.
When I asked Dr. Desmond-Hellman about doctors' future role, she repeatedly brought up the role of caring and empathy. "There are certain parts of that interaction between a patient and a physician, a caregiver, that is extra special – asking the right questions, laying on hands, caring, understanding what’s going on in a way that Watson still can’t do," she said.
Of course, doctors can be wonderful, comforting, and inspirational figures.But I suspect if most people were candid about it, they would say the real, deep, empathetic work of caring best comes across from nurses. It's nurses who handle nervous family members. Who do the dirty work of sheets and blood and urine. Who lay on hands, as Dr. Desmond-Hellmann would put it.
Perhaps this will be a small and strange change of our technological future: A world that venerates the nurse's credo more than the doctor's intellect.
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