DOCtalk by Dr. Gregg 11/22/13

Big Data, Self-Care, and a DeLorean

Feeling bored the other day, I decided it was time for a road-time trip. Thus, I pulled out the DeLorean, threw a stale grilled cheese into the Mr. Fusion, cranked up the flux capacitor, hit 88 MPH, and headed off again to the future. (I won’t say when, because I don’t want to scare folks. Let’s just say it’s sooner than you might expect.)

After exiting the space time continuum, I decided to drive over to my doctor’s office to see what had become of healthcare. Sadly, it had been replaced by a Walmart. (I noticed an amazing number of Walmarts on the way there, by the way.) Noticing a caduceus logo now featured just below the main sign, I pulled up and walked in.

A big “Wal-Care” sign was prominently positioned just inside the entry with the caduceus logo to its right. I turned in to see an array of kiosks and cubbies occupied by people tethered to digitalia and discoursing with holographic talking heads floating eerily in space above each counter. I noticed one real, white-coated person walking around and went up to make some inquiries. Her lab coat had “Dr. Cammy” embroidered above the right breast pocket.

“Dr. Cammy,” I started. She turned and smiled. “Might I ask you a few questions?”

Her smile grew larger. “Oh, my, yes!” she exclaimed with a rather mixed expression of surprise and joy. “I get so few questions these days. How can I help …” She stopped mid-sentence. “Wait…I know you…you’re that guy, that doc with the DeLorean,” she said with both pronouncement and query.

I smiled, sheepishly. “Guilty,” I say.

“So, you’re actually here from 2013, right?” she asked.

“I am,” I acknowledge.

“I’ll bet you’re curious about all this,” she said as she swept her left hand across the room.

“You’re very insightful,” I say.

“Thanks. You know, I don’t get to use my insight much anymore. Healthcare has changed so, so dramatically. I’m more custodian than caregiver, it seems. After the ‘BD&W Meld,’ the self-care appsets sort of took over, relegating docs to more monitor than mentor roles. Well, that’s true for those docs who could continue to find work anyway. I read somewhere that the majority of displaced doctors appear to have ended up selling either Amway or Mary Kay.”

“Whoa, whoa, whoa…a little fast for me,” I interrupt. “Doctors are disappearing? Self-care apps took over? And what’s this ‘BD&W Meld’ you mentioned?”

“Oh, I’m sorry,” she apologized. “That’s right. In your day, doctors were still pretty revered, weren’t they? Well, they were sometimes. All that has really changed, let me tell you. How can I condense the events…? OK. OK. I know. Remember when everybody used to go to the doctor when they were sick?”

I nod.

“Well, now that there are so many self-care appsets and devices available– and so cheap – that people go to themselves, so to speak, instead of someone else when they’re ill. They can scan and measure and examine almost anything, right from home,” she exclaims, a little bit sadly. “It doesn’t leave a whole lot for healthcare providers to do.

“For folks who don’t have the latest and greatest tools at home, they can come here and use one of our Wal-Care kiosks. It doesn’t even cost them anything, as long as they make a minimum in-store purchase.”

“Hmmm,” I ponder, trying to look less shocked than I felt. “What if they need surgery or chemo or radiation treatment or some such?”

Dr. Cammy looked around the room to see if anyone needed her. They did not. She sighed, just a smidge, and continued, “Well, between personalized genomics, robotics, Big Data, and Sir Watson, there’s far less need for ‘real’ doctors to get involved. People don’t get nearly as much invasive care anymore, not like in your day. When they do need some form of procedure, heck, sometimes they can schedule it themselves, show up, have the procedure, hang out in auto-post-op a bit, and head home without even seeing a live person.”

“Um,” I stumble, “you mention ‘Sir Watson.’ Who is tha… wait… no… you don’t mean ‘Watson,’ the IBM computer, do you?!”

“Yeah,” she chuckles. “Can you believe it? Good old England’s Queen Latifah III, herself, knighted Watson a couple of years back. It made all the news threeds. The first non-human in history to receive knighthood.”

“Threeds?” I say quizzically.

“Oh, right. You didn’t have those yet. Threeds are ‘3-Ds.’ It’s how most content is delivered anymore. Like those holographic talking heads all these people are talking with,” she said as she pointed across the room.

I think I see the connection and ask, “So then, is that the ‘BD&W Meld’ you mentioned? Big Data and Watson? Or should I say, Sir Watson?” My smirk leaks out a bit more than I intend.

“Yep, sure is,” she admits. “When they finally figured out that they could take all that mega data folks were collecting – which was mostly just sitting on a gazillion different servers doing nothing – and feed it to Watson, things went bananas. Watson just sort of looked like the Second Coming to some, spewing out all these connections that no one had ever even dreamed existed. He literally changed the world, even more than Saint Jobs. That’s how it earned its royal dubbing, even though some folks in healthcare thought it more an Antichrist than a savior.”

My mind was reeling. Big data had finally found use, but its use put providers out of business? People could now take their healthcare into their own hands – and devices? Walmart had become the major primary care player? Watson was now a ‘sir’? Jobs a saint?

“Dr. Cammy, I feel sort of faint,” I admit, feeling the wooziness all the way to my toes.

“Oh,” she says with disappointment. “Kiosk 7,” she directs.

From the trenches…

“The future ain’t what it used to be.” – Yogi Berra

Dr. Gregg Alexander, a grunt in the trenches pediatrician at Madison Pediatrics, is Chief Medical Officer for Health Nuts Media, an HIT and marketing consultant, and sits on the board of directors of the Ohio Health Information Partnership (OHIP).