This Should Be the Best Time to be a Doctor, But It's Not

This is an op-ed from Cosima Gretton, a doctor who has worked part-time at Bay Area health-technology startups.

There’s a huge disparity going on in healthcare. The digital health hype is at an all time high. It seems like every day, I read a new article stipulating that technology is ‘revolutionizing healthcare.’

But inside hospitals, the story is very different.

I work as a doctor at a well-known hospital in London. Technology is changing rapidly in other sectors, but health care is having a hard time keeping up. Outdated IT systems are compounding the stress that doctors already experience in their daily lives, as well as making it more difficult to interact with patients. In the U.S., a recent survey found that only six percent of doctors are satisfied with their jobs, in part due to the poorly-implemented electronic medical record systems.

This situation may get worse before it gets better. In the U.K., where I work, there is a current row over contracts that would increase working hours while cutting our pay by as much as 40 percent. Globally, there’s a huge lack of doctors: the U.S. alone will face a shortage of between 46,000 to 90,000 physicians by 2025, according to the Association of American Medical Colleges. It's a supply and demand problem: It takes more than a decade of expensive training for doctors to care for the growing pool of aging patients.

Unfortunately, all this discontent impacts on patient care: tired, unhappy people don’t make the best physicians. And with more doctors leaving the profession, the workload for those that remain may become untenable. Greater workload means less time spent with each patient, or the prioritization of only the very unwell over others who may also be in need.

In my hospital, for example, there are 19 different software systems across the departments, few of which communicate data with each other. This quadruples the administrative work that doctors do and reduces time spent with patients.

Compounding the crisis is the fact that core medical education has not been upgraded for the 21st-century. As a graduate medical student, working part-time with health technology startups on both sides of the Atlantic, I was amazed to find such a disparity between my medical school curriculum and the technology for patients and doctors already on the market.

So What Can We Do?

To begin with, medication education needs a major upgrade and rebrand to attract the next generation and improve the doctor-patient relationship.

One potential solution lies in post-graduate education. Some recent initiatives are moving in the right direction, adapting the profession for the future and making it more attractive to young doctors.

At the John Hopkins Sibley Innovation Hub in Maryland, they have trained over 200 doctors in design thinking, giving them time and skills to innovate and improve the system that they work in. Harvard Medical School recently overhauled its curriculum to include a new focus on health policy and regulation. 

We also need to see a more drastic shift in consultation styles, shifting away from paternalistic medicine and more toward the patient. Consumer-facing technology giants like Apple are driving this further, putting diagnosis and management of many diseases into the patient’s hands.

One physician who is leading the push to a more patient-centric practice is Eric Topol, a cardiologist and author of 'The Patient Will See You Now.' Topol told me that many of his patients use a smartphone-based heart monitor called the AliveCor.

“My patients think they are having a major arrhythmia, they put their fingers on their phone sensors, realize they are OK and don’t go to the doctor," he told me. "When they do, armed with their information, the doctor becomes more of a co-pilot in managing their care.”

Finally, the potential for technology and a new era of genomic medicine to bring about a radical change in the way we deliver services is huge. It’s an exiting time to be in healthcare, but it sure is a difficult time to be a doctor. It's time we changed that.