The Disenfranchised Physician and the Digital Health Revolution: Will We Take an Active Role?

For the first five years of my career, I practiced dentistry and dental anesthesiology. I then returned to medical school for my MD and completed my anesthesia residency and fellowships at Harvard’s Brigham and Women’s Hospital. I practiced anesthe- sia for over 30 years in Berkeley while holding various administra- tive and medical staff positions. Over these years, I also had the opportunity to participate as a serial entrepreneur in the digital health space as a founder, co-founder, investor, advisor, and enter- prise physician informatics lead for a 27-hospital system based in Northern California. This wide variety of activities has afforded me a unique window into the world of health care entrepreneur- ship and investing. It has provided me an up-close opportunity to meet with, interact with, and provide support at the elbows of hundreds of clinician and executive colleagues, both domestically and internationally. Having worn so many “operator” hats has, in addition, afforded me the opportunity to develop a way to bridge the gap between physicians and digital health entrepreneurs, healthcare investors, and healthcare C-suite executives.

Doctors in general are highly intelligent, generate great ideas, and are motivated to help people. What I have experienced is these same professionals are not savvy in their understanding of the business and investing side of the equation. In fact, the mesh- ing of those two cultures is an enigma to most of us, because we are neither classically educated nor wired that way. That said, physicians can be trained and taught the perspective of the busi- ness and investing world, given the proper tools and collaborative environment.

The burnout rate for physicians is rising exponential- ly, approaching 70% in the southeastern US. Private practice incomes are dropping, expenses are rising, and work demands are increasing. The average educational debt for young physicians is becoming unmanageable. The initial wave of digital health has forced on our profession the implementation of electronic healthcare records introduced with the promises of improved documentation and efficiency. Instead, we see clinicians spending increasing amounts of their time looking at a computer screen instead of caring for patients. Practitioners are now expected to spend less time with each patient, and in some cases, they are ona timer. The ability to practice individualized private medicine is increasingly limited, and standardized medicine is becoming the norm, resulting in loss of power and authority where it matters the most – clinical decision making.

The amount of educational information a practitioner has to assimilate is overwhelming, and without the assistance of digital technology, it is almost impossible. The feedback I frequently hear as our colleagues look at medicine, and at the changes in the patient/provider relationship over the last 20 years, is the overall sentiment of, “This is not what I want to do.” They don’t want to be an employed physician, which is what most physicians who come out of medical school now become. It doesn’t take an oracle to recognize that there is a pandemic of dissatisfaction sweeping over our profession. The symptoms described above are manifold, and the root issue is the disenfranchisement of the practicing physi- cian in the US.

In the midst of exponential technological growth, we are at what I believe is the second wave of the digital healthcare revolu- tion. Electronic health records were the opening salvo, and now we are seeing a tsunami of clinical platforms, noninvasive digital sensors, telemedicine and telehealth platforms, virtual reality, artificial intelligence applications and data companies sweeping over every aspect of medicine. Technology tracks how and when we wash our hands, where we access patient and clinical data and information, and how we communicate and collaborate. Online meetings have replaced physical meetings and just-in-time access to information impacts clinical decision making at the point of care.

I firmly believe that health care professionals need to reassert our influence and judgment in the process of technology develop- ment and its influence on care delivery. We need to be active par- ticipants in the process as investors, advisors, entrepreneurs, and beta testers. How and where do we start, you may ask? My team and I have been working on a solution. We have been building a strategic health professional–driven, digital innovation collab- orative network where clinicians have the opportunity to actively participate in the digital healthcare revolution. We can participat as advisors, investors, and users, helping to mold our future of a health care system that improves access, efficiency, safety, and care – and at the same time, decreases the cost of care. Best of all, this can and will ultimately be a global impact solution, improving health care available everywhere. If you are interested in joining the evolution/revolution, contact me at Gary@globalhealthimpactnetwork.net.