I was invited to attend a private breakfast with book author, surgeon, and New Yorker contributor Dr. Atul Gawande shortly before Dr. Gawande’s talk at The New Yorker Festival. Over breakfast, Dr. Gawande spoke with IBM executive Dr. Paul Grundy on the future of health care. The event was sponsored by IBM so there was plenty of talk about how technology can and will influence the practice of medicine—from big-data diagnoses and personalized medicine to enhancing doctor-patient communications.
But, to me, the big question Dr. Gawande raised was this: Can technology be a change agent for health care? The inevitable answer is yes, with one important caveat. It’s not the technology that will change the practice of medicine, it’s the doctors who use the technology who will end up changing it. And it won’t come overnight. Many of the most influential doctors practicing medicine today have an antagonistic relationship with computers. Change will only come in a massive way when the under-40 generation takes control.
Under-40s expect technology as impressive as Facebook, twitter, kayak, and tumblr to influence each and every moment of our practice. My generation simply doesn’t know how to live without the Internet. However, we’re not yet leaders and technological decision-makers in our health-care system. Our parents are heads of hospitals, chairwomen of departments, and CTOs of health-care delivery networks. When this generation of boomers retires this decade, we’ll see massive change. It’s not their fault. Technology, the internet, and iPhones simply aren’t in their DNA.
I’m 37 years old and graduated medical school in 1998, four years after Amazon.com was founded. I had my first computer in 3rd grade— a Commodore 64. Of course it wasn’t connected to the Internet, but I grew up tinkering and exploring and using my imagination to see how I could use computers to make my life easier and more fun. When I couldn’t figure something out on my computer, I quickly realized I couldn’t ask the wisest man I know—my own father. He was absolutely no help, and today at age 65, he’s still no help. He still thinks he’s going to break the Internet. Computers stress his generation out.
I see this every day in my company. We’ve built an online platform that allows patients to message our doctors and have an online conversation to either treat medical problems or refer to the most appropriate healthcare professional in the neighborhood. I’ve hired two generations of doctors— one from my parents’ generation and one from my own. The differences are striking. One feels right at home, empowered and enabled, and the other thinks she’s going to break something. The older physician still loves what she does, and enjoys learning out of curiosity, but computers just aren’t hard-wired into her brain like the younger one.
I speak to medical students on a regular basis about creativity in health care and I open up every conversation with one question: “Who is the youngest one here?” Some precocious kid always raises her hand and says “I was born in 1992.” She’s just a few years older than Amazon, Facebook and the iPhone. Leaving her iPhone at home is anxiety-provoking and socially isolating for her. In just a few years, she’ll be the resident treating the current health-care leaderships’ broken hips in the ER. If she doesn’t have her smartphone with its suite of professional tools that enable her to practice medicine as effectively as purchasing a plane ticket or keeping up with her friends and family, quite simply, she’ll feel anxious and lost.
It’s been said that the Internet is the greatest generational divide since rock-n-roll. My grandparents’ generation didn’t know what to do with the Beatles. My parents didn’t know what to do with the Internet. My generation doesn’t know what to do without the Internet. There’s a sea change coming in health care. It’s not due to amazing new technological tools. It’s due to a new guard of health-care professionals providing new forms of leadership with new behaviors and expectations, demanding the use of familiar tools in their everyday practice. As a physician, I couldn’t be more excited about ushering in these new technologies to help doctors be better doctors and patients be better patients.