The Future of Medicine

A Wave of Hospital Mergers

futuredoc@medicalmegatrends.com (Stephen C. Shimpff, M.D.) — Mon, 16 Jun 2008 19:44:39 -0500

Here is a new megatrend. There will be a wave of new hospital mergers in the coming years. Hospitals need to access capital in order to purchase expensive equipment and build new facilities. But margins are getting very thin and access is very difficult for the smaller, stand alone hospital. So look for many mergers soon.

Primary Care Physicians - A Shortage

futuredoc@medicalmegatrends.com (Stephen C. Shimpff, M.D.) — Fri, 06 Jun 2008 11:29:11 -0500

We do not have enough primary care physicians [PCPs] and the shortage is especially acute in rural and urban poor areas. In the USA there are about 30% PCPs and 70% specialists. In other countries of the developed world, the ratio is the opposite. And PCPs now need to attend to many more patients with complex, chronic diseaes that last for life and require a team-based approach to care. Rather than be an interventionalist, the PCP must become an orchestrator.

The Growing Demand for Medical Services

futuredoc@medicalmegatrends.com (Stephen C. Shimpff, M.D.) — Fri, 23 May 2008 13:02:49 -0500

The population is growing; we are aging; and more and more individuals have not curable acute illnesses but complex, chronic conditions that will persist for life. As a result there is a need for more and more medical services including physicians, other care givers, hospitals, ICU beds and high tech equipment. And there is a critical need for a change from our acute care approaches to disease and care management, team-based care and better coordination of care.

The Costs of Aging and Behaviors

futuredoc@medicalmegatrends.com (Stephen C. Shimpff, M.D.) — Mon, 28 Apr 2008 09:38:55 -0500

Increased age and our lifestyle behaviors have a major impact on healthcare costs. Like an older car, an older body has parts that are more likely to need repair or replacement. We will continue to age but we can slow the process of aging with mental and physical exercises. As a society, we are overweight, poorly fed, highly stressed and lack exercise. These behaviors along with smoking will lead to huge increases in our total medical costs in the years to come.

The High Cost of Drugs

futuredoc@medicalmegatrends.com (Stephen C. Shimpff, M.D.) — Thu, 17 Apr 2008 08:20:51 -0500

New pharmaceuticals have had a major impact on health and life, but many of the newer drugs are prohibitively expensive. Some are marginally valuable. Others are superb drugs but are all too often used in lieu of making life style changes that would eliminate or at least modify the underlying problem. We need to change our approach to expecting a drug to solve our problems when simpler, less expensive approaches would work even better.

The High Cost of Medical Technology

futuredoc@medicalmegatrends.com (Stephen C. Shimpff, M.D.) — Wed, 09 Apr 2008 14:37:41 -0500

Medical technologies are often very expensive. The question at hand is are they worth it or do they just drive up the already high cost of medical care? In this podcast we explore how some technologies are very useful but need to be used only when necessary.

Healthcare Reform Part I - Insurance

futuredoc@medicalmegatrends.com (Stephen C. Shimpff, M.D.) — Sun, 23 Mar 2008 18:47:00 -0500

The United States is the only country in the industrialized world that does not assure insurance to cover the catastrophic medical care costs of all its citizens. But Republicans and Democrats differ widely on how to address this problem. Here is a proposed compromise that offers universal coverage but with a change in the tax code, more personal responsibility for behaviors, and reduced insurance costs through lessened mandates. It also returns to true insurance, not prepaid medical care. Use high deductibles and HSAs but offer primary care and preventive care to those who truly cannot afford it.

Recap of Medical Megatrends Part II

futuredoc@medicalmegatrends.com (Stephen C. Shimpff, M.D.) — Thu, 13 Mar 2008 08:43:58 -0500

As a result of engineering and computer science advances we can expect to see major improvements in imaging - both anatomic and now also molecular or functional imaging; smaller and more powerful medical devices; big changes in the operating room including simulation and robots; and a functional electronic medical record. Look for acceptance of complementary medical techniques such as acupuncture, massage and meditation. And expect hospitals to become more safe for you and your loved ones.

Recap of Medical Megatrends Part I

futuredoc@medicalmegatrends.com (Stephen C. Shimpff, M.D.) — Mon, 10 Mar 2008 19:07:12 -0500

We review here the five basic medical megatrends that will occur in the coming five to fifteen years including the concept of customed-tailored medicine, the change from "diagnose and treat" to "predict and prevent;" repairing, restoring or replacing tissues or organs; the advent of truly electronic medical records and fewer preventable medical errors. Look for major advances in genomics, stem cells, vaccines and transplantation as a result of much greater understanding of basic biomedical science.

Your Medical Information

futuredoc@medicalmegatrends.com (Stephen C. Shimpff, M.D.) — Mon, 05 Nov 2007 16:12:46 -0600

Your medical record is indeed your medical record even though it may be currently stored in your doctor’s office or the hospital’s record room. You need to have ready access to that information and need to be able to pass it on to any healthcare provider you choose, securely.

The Electronic Medical Record - Part Two

futuredoc@medicalmegatrends.com (Stephen C. Shimpff, M.D.) — Tue, 30 Oct 2007 14:00:04 -0500

"The electronic medical record will arrive over the next decade, but inparts and pieces. It will become your medical record, not the doctor's or hospital's. Your record may be on a a chip in your pocket or instantly available from the internet."

Electronic Medical Records

futuredoc@medicalmegatrends.com (Stephen C. Shimpff, M.D.) — Mon, 22 Oct 2007 14:37:01 -0500

Full digitization of medical information – which will still take 5 to ten years or more to achieve - will allow access to medical information at any time, at any place, and in so doing will greatly improve the quality and safety of medical care—your medical care. Digitization will assist continuity of care by providing the right information at the right time to allow for the correct choices in care. Telemedicine and distance medicine will prevail.

Robotics

futuredoc@medicalmegatrends.com (Stephen C. Shimpff, M.D.) — Mon, 15 Oct 2007 08:16:03 -0500

Robotics will become as important in surgery as industrial robots have become to manufacturing. They can overcome certain obstacles or barriers, such as accessibility to certain tissues (small incisions), distance (telesurgery), dexterity (the six degrees of freedom or a wristlike motion), speed and they do not get tired. They offer the potential to transcend certain human limitations to increase consistency and quality.

Imaging and Simulation in the OR

futuredoc@medicalmegatrends.com (Stephen C. Shimpff, M.D.) — Mon, 08 Oct 2007 08:25:13 -0500

Tomorrow's operating rooms will be highly dependent upon breathtakingly superb images that will allow the surgeon to know - in advance - what to expect during a specific individual's surgery. And simulators will be universally used by trainees before ever being allowed into the OR. The measure will be competence, not just numbers of cases done. Better surgery and better training.

Less Invasive Surgery

futuredoc@medicalmegatrends.com (Stephen C. Shimpff, M.D.) — Mon, 24 Sep 2007 10:59:42 -0500

As medicine advances, there will be less need for surgery and the surgery done will be much less invasive. Some procedures traditionally done in the operating room will now be done in the radiology department using catheters rather than scalpels, in shorter time frames and will less recuperation time needed.

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The Operating Room of the Future

futuredoc@medicalmegatrends.com (Stephen C. Shimpff, M.D.) — Mon, 17 Sep 2007 07:57:59 -0500

The OR of the Future has four major megatrends. Fewer procedure will need to be done. Many procedures will be done outside the OR. The OR will have much more functionality. The OR will depend on new technologies such as simulators, image guidance and robotic assistance.

Nanomedicine

futuredoc@medicalmegatrends.com (Stephen C. Shimpff, M.D.) — Wed, 05 Sep 2007 12:50:11 -0500

Nanomedicine - Ever more small devices are being created now with sizes so small that they cannot be seen with a microscope -- but they can help in diagnosis and treatment in ways never before available. For example, a nanodevice an find a tumor cell, attach to it, show where it is on an image and then deliver a drug to destroy it.

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Devices

futuredoc@medicalmegatrends.com (Stephen C. Shimpff, M.D.) — Mon, 27 Aug 2007 07:21:54 -0500

Smaller and more powerful devices with very long battery life have been created to help control the heart beat, improve heart pumping, decrease the number of epileptic seizures and even decrease depression for those not well treated by drugs. Soon there will be insulin pumps that can sense the body's blood sugar level and inject just the right amount of insulin -- and many more to come.

Imaging

futuredoc@medicalmegatrends.com (Stephen C. Shimpff, M.D.) — Tue, 21 Aug 2007 07:58:05 -0500

What we used to call "X-rays" are dramatically changing with superb anatomic images that show some of the smallest details of our organs and the ability to "see" actual function within tissues and cells. And they are not just used for diagnosis anymore but for actual therapy of problems formerly treated in the operating room. With all of the information in digital format, images can be viewed at anytime, at anyplace and by any (authorized) person.

Vaccines

futuredoc@medicalmegatrends.com (Stephen C. Shimpff, M.D.) — Fri, 10 Aug 2007 18:32:31 -0500

Expect new vaccines to prevent not only infections but also to prevent and treat many chronic diseases like multiple sclerosis, coronary artery disease, and Alzheimer’s. And their will be vaccines designed specifically for an individual – custom tailoring again – to treat residual cancer.

The Promise of Stem Cells

futuredoc@medicalmegatrends.com (Stephen C. Shimpff, M.D.) — Thu, 02 Aug 2007 19:41:08 -0500

Let’s get away from all the hype and look at what stem cells might actually do - such as help regenerate the damage to the heart after a heart attack or create new pancreas islet cells to replace those lost to type 1 diabetes.

Genomics and Targeted Drug Therapy

futuredoc@medicalmegatrends.com (Stephen C. Shimpff, M.D.) — Thu, 26 Jul 2007 15:24:39 -0500

The genomics revolution will mean a whole new approach to drug development and therapy. Drugs will be designed for a specific target, will have fewer side effects, will be much safer. They will be prescribed specifically for your problem with an understanding that your body will respond and not suffer adversely.

The Era of Genomics

futuredoc@medicalmegatrends.com (Stephen C. Shimpff, M.D.) — Thu, 26 Jul 2007 14:45:45 -0500

Medicine is rapidly changing – for the better. A major megatrend is that you can expect to have much more personalized medical care – tailored just for you - in the years to come. Genomics for example will allow your doctor to predict what diseases will occur in your future and then prescribe a plan of action to prevent you from developing them.

Megatrends in Medicine

futuredoc@medicalmegatrends.com (Stephen C. Shimpff, M.D.) — Thu, 26 Jul 2007 14:42:39 -0500

The medical megatrends coming over the next five to fifteen years include drugs with specific targets to attack with fewer side effects, X-rays that take previously undreamed of pictures of our anatomy and even image your cells metabolic function, operations done with less invasive techniques and some done by robots, and devices that can control heart rhythm or even pump for it.

Prediction and Prevention

futuredoc@medicalmegatrends.com (Stephen C. Shimpff, M.D.) — Fri, 29 Jun 2007 11:05:38 -0500

Genomics will improve your doctor’s ability to diagnose disease and plan a specific approach just for you – personalized or custom tailored medicine. Your physician will also be able to predict if your cancer is likely to recur after treatment and, if so, what the best approach to cure will be.