The Biggest Question of 2030: What Were We Thinking?
The big prediction: As Cy Wakeman wrote in her book “No Ego,” the only flavor change comes in today is “fast and furious,” she wrote. “Our pain is not from the changes in our lives but from our resistance to those changes.”
But to truly understand 2020, we have to understand 2030 – let’s fast forward and imagine: In ten years, what will we shake our heads and think: What were they thinking in 2020?
1. In 2030, we will be puzzled that we spent so many years arguing about how to pay for a broken, fragmented, expensive, occasionally unsafe, and deeply inequitable healthcare delivery system. Every single week in 2020, candidates at every level will debate the future of healthcare in this country. My hope is that 2020 is when we face hard reality – it’s bad. It needs radical transformation. We need in 2020 the first steps toward the 2030 goal of a system founded on “health assurance,” keeping people well instead of waiting to intervene when people are sick.
2. In 2030, we will laugh that healthcare was the last holdout in the consumer revolution and that we still talked about technologies like telehealth as something novel, or different. Even banking in 2020 had moved from the “bank” to “home.” 2020 is when the locus of health starts to shift to the home – virtual hospitals, retail medicine, and a new focus on assuring health, not fixing sickness, will take root as even older generations get tired of waiting, and driving, and parking, to access even simple encounters with the legacy system.
"In 2030, we will laugh that healthcare was the last holdout in the consumer revolution..."
3. In 2030, we will be angry that in 2020 we still accepted medical students based on science GPA, multiple choice tests and organic chemistry grades and then were amazed that doctors were not more empathetic, communicative and creative. In 2030, we’ll allow robots to do all the memorization stuff … and select students for all the health professions who can answer when a patient asks, “What does this mean?” We will start to select for wisdom, not standardized test proficiency. In fact, at Thomas Jefferson University, we started in 2020 the first institute for inter-sentient education – developing best practices as human minds and computer algorithms work seamlessly together.
4. In 2030, we’ll credit those who in 2020 recognized that ethics and trust are the core values in the development of digital health technology. In 2020, smart people will put ethics first – when defining the value proposition for a digital health product – instead of waiting until a new tech is developed and then asking marketing to make it sound trustworthy. 2020 was when we knew we had to put the human in the middle, not the machine.
5. In 2030, we’ll admire those who stepped forward to invest in the economic and social determinants of health. If our mission is assuring health, then poverty is our greatest enemy. In cities like Philadelphia, and Baltimore, and Chicago, we have too long ignored the inconvenient truth— that cities with several prestigious academic medical centers have the highest discrepancies in life expectancy by zip code. 2020 is when we’ll realize that patients cannot enjoy virtual health services, if they don’t have data plans. That health depends more on education and employment than on hospitals. We’ll further admire those who recognize that technology can be a tool to help those who have less, not just enhance life for those who have more.