Message to doctors: What we can all heed from Bob Dylan when responding to changes in health care
For the times they are a-changin’
This is a message to anyone who is younger than me…and that means students, residents, recent graduates, not so recent graduates and even those among you thinking of retirement!
Let’s not be afraid to embrace change. Indeed, let’s be restless for it. Of course, we have all seen many changes that have occurred in our health care environment so change is not anything new. But I would argue that the pace of change in the near future is going to rapidly accelerate and our natural aversion to change (cognitive dissonance, in psychological terms) may serve as an impediment to progress unless we adopt a personal mandate to challenge ourselves to welcome change and improve the health system.
A revolution of change
In his recent book Sapiens, Yuval Noah Harari speaks to the three major revolutions of mankind: the cognitive revolution, the agricultural revolution and the scientific revolution. I would posit that we (and especially those of you in the early stages of your career) are now living through mankind’s fourth major revolution: the digital revolution.
And how lucky are we for that!
Technology will certainly have a profound effect on medicine. Future interactions with our patients won’t, in many ways, at all resemble the interactions that those of my generation are used to. Instead of waiting rooms, faxes and an appointment in three months, we will — and are already seeing this happen, given lessons from the pandemic — transition to more electronic consults, virtual visits with patients, electronic prescribing and text messaging for rapid fire communication.
The digital revolution will even challenge the essential nature of specialty medicine. My own specialty was colorectal surgery. There is absolutely no way that, in 50 years, future surgeons will operate on colons the way that I did. Artificial intelligence (AI) will predominate in diagnostics and smart robots will do surgery in more precise ways than we could have ever dreamed. And I’m confident that the same will be true for all, if not most, specialties.
In our recent Royal College Task Force on AI and Emerging Digital Technologies, we quoted medical futurist Bertalan Mesko, who said that AI may be the great democratizer of health care. Given the prospective impact of natural language capabilities of future machines, and their ubiquitous use in an AI-enabled health care environment, the very nature of the patient-doctor interaction may fundamentally change.
It is up to us to be adaptable, innovative, creative and not afraid to accept change.
Let me tell you an interesting story
While I was on sabbatical a few years ago, I had a very interesting conversation that made it clear to me just how profoundly the digital revolution is going to shape the careers of our youngest colleagues.
I was visiting an organization in London, England, that is owned by Google. Called DeepMind, its health division explores the interface of AI and health care. While I was talking to some of the many people who work there, I met a young woman who had recently graduated from Stanford University School of Medicine. To me, this was a little strange. What was someone who had just graduated from a prestigious medical school doing working in the tech industry and not pursuing residency? But she made it clear to me that going to work for DeepMind was her first choice after graduating. She said that it had been her goal to work for a company that focused on developing AI for health care. Even more surprising, she said that many of her classmates at Stanford had similar goals. By her estimate, 1/3 of her graduating class planned to pursue non-traditional medical careers, many in health care technology.
In my generation, there was only one reason to go to medical school: to become a practising physician. Things aren’t that straightforward now. Maybe that’s a little scary but it’s also incredibly exciting. Because, with innovation and even iconoclastic approaches to today’s health care challenges, we could be at the cusp of an amazing future.
Nurture that same spirit that led you to medicine
I remember, as a recent dean, telling our medical students “you are going to have to be open-minded and flexible as you go through your careers. You’ll need to take up the technological revolution — grasp it, capture it and get it working for you. Under your control, new technologies will change the way we deliver health care. But I’m confident it’ll be for the better. And to do that you are going to have to foster and intensify your creative and innovative spirit. The same spirit that got you into medical school. Please don’t lose it.”
For many of us, a long way from our days in medical school, I believe the message is still the same.
We know our Canadian health care system needs adjustment. Many of the issues we are now facing preceded the pandemic. If anything, the last two years has just brought them in to sharper focus. As we look ahead, we need to embrace significant change to rebuild a stronger and more resilient health workforce and care system.
Some of us have leadership roles — this provides an opportunity to influence evidence-based, system-level improvements.
Some of us have teaching roles — let’s inspire our trainees to be even better doctors than we have ever seen or imagined.
Some of us may be involved in advocacy — our voices can be effective in promoting fairness, equity and a judicious use of our resources, especially when those voices embrace change.
No matter what specialty or in which setting you practice, we could all benefit from being a little bit restless for change because, at its heart, that is where creativity, innovation and improvement stem from.
I’m not sure Dylan was talking about artificial intelligence or health care system change when he wrote the stanza below but he could have been delivering us an important message:
May your hands always be busy
May your feet always be swift
May you have a strong foundation
When the winds of changes shift
May your heart always be joyful
May your song always be sung
And may you stay
Richard K. Reznick, MD, MEd, FRCSC, FACS, is the 46th President of the Royal College of Physicians and Surgeons of Canada. He is the founding director of the Wilson Centre and previously served as chair of the Department of Surgery at University of Toronto and dean of the Faculty of Health Sciences at Queen’s University.