CARDIOLOGISTS WILL BE USING A LOT MORE TECHNOLOGY
What about cardiologists? Besides becoming more preventive, cardiology will be much less intuitive and much more technical. “The number one killer in most of the Western world is heart disease,” Kraft told me. “Most folks learn that they have heart disease only after they have a heart attack or a stroke. In the future, a cardiologist will be able to use new tools like cloud-based computing to do a CT scan of the heart and send that data to the cloud and compute how narrow the blood vessels might be without being invasive like with the angiogram, where you insert a needle into the groin and run it all the way up to the heart.” Other tools cardiologists will increasingly use are stents and other devices that can be custom fit to an individual patient with the use of a 3-D printer, instead of having them mass produced as they are today.
And patients will have new tools as well to monitor their own heart. The simplest of these will be virtual assistants on our phones, like Siri, or in the form of boxes, tubes, or more humanoid robots like Alexa. But there are other devices available to patients that are much more sophisticated. “You can go on Amazon and buy a little sensor you can put on your phone to look at your EKG,” Kraft says. “Patients can use this to screen themselves to see if they have a heart condition, or a doctor can use it to keep better track of a problem remotely.”
Pulling another gadget from his box, Kraft went on: “For example, this little patch: it’s like a Band-Aid that I can wear under my shirt, and it tracks my EKG 24/7 as well as my posture, my respiration rate, my temperature, and it sends all that information to a physician. Now, it’s true that most cardiologists won’t want to look at that data 24/7. We’re going to need to use smart software to look at those signals and alert the doctor and the patient only when something seems wrong,” he explained.
MICROBOTS WILL BE WIDELY USED WITHIN THE NEXT TEN YEARS
Kraft believes that microbots and nanobots like the one Shoham is developing in Israel to clean the plaque from inside the blood vessels will become widely used within the next ten years. “The trend for many technologies is to get exponentially smaller, smarter, and less expensive,” Kraft said. “We already have some robots the size of a pill that you can swallow and that will go down to your stomach and take pictures, replacing the need for an endoscopy. At MIT, we’ve seen similar little robots that can crawl through your GI tract and possibly help remove foreign objects or do a better job of diagnosis and treatment. We’ve also seen some work at Stanford, where they’re making little microbots that are small enough to go through blood vessels.”
Isn’t it overly optimistic to think that we’ll be using these microbots in less than a decade? I asked. Kraft shrugged. “Well, think of what’s happened in just the last ten years,” he replied. “Ten years ago, we didn’t have smartphones, we didn’t have Twitter, we barely had the early versions of Facebook. Those are just some of the things that have happened in just the past decade. A lot more will happen in the next ten years as technology accelerates with Moore’s law and computing becomes cheaper. You know, we now have 4G smartphones. In a few years we’ll have 5G smartphones, which will be able to transmit a hundred times more data in terms of speed and power….In ten years, we may have things that would look as magical as some of the technologies we have today would have looked ten years ago.”
INTERNISTS HAVE A BRIGHT FUTURE
Much to my surprise, Kraft said, “I think the future of the general practitioner, the internist, is actually quite bright. We still need that quarterback primary care doctor who is going to be using some of these technologies and tools to be able to do their job.” But he also expects the role of the primary care doctor to change: instead of sitting in an office with a line of patients waiting to see him, he’ll do most of his work over the phone or through Skype sessions. “I think many appointments in the future will be done through our computers, through our laptops, through chat bots like Siri,” both in big cities and in rural areas, he explained.
“You might be a physician in rural Brazil, in the Amazon, or a nurse in a rural village in Argentina or Chile, where it might be a hundred miles to the closest city,” Kraft said. “Using some of these tools and technologies you can fit in your pocket will allow you to do a much better job of taking care of patients, in terms of both diagnostics and therapy. I think the general practitioner will be able to use these new tools, whether it’s digital electronic detection devices or mobile devices that can be used to perform an ultrasound anywhere. They might even be using drones to deliver drugs and devices to remote locations. I don’t think the role of the primary care doctor is going away, but their ability to use technology and to use it to communicate with their patients will change.”
Indeed, in 2018, my insurance company sent me a promotional printed brochure offering me—without being asked—a telemedicine service. For what it said would be a much lower cost than a trip to the doctor’s office, Aetna offered virtual medical consultations “24/7 by web, phone, or mobile app.” The service, called Teladoc, allows you to “talk to a U.S.-licensed doctor by video or by phone for diagnosis and treatment plan. If medically necessary, a prescription will be sent to the pharmacy of your choice,” it said. What Kraft had predicted as a trend of the future was already spreading far and wide just months after I had interviewed him.
PSYCHIATRISTS AND PSYCHOLOGISTS HAVE NOTHING TO FEAR
Virtually all studies on the future of jobs agree that psychiatrists, psychologists, and other mental health professionals are among the least likely to be replaced by robots. According to the Oxford University study by Carl Benedikt Frey and Michael Osborne, mental health professionals will have less than a 1 percent chance of being replaced by intelligent machines. Out of the 702 jobs that were included in their index, psychiatrists and psychologists ranked among the 5 safest from technological disruption.
Kraft agreed with that forecast, but added that intelligent machines will help psychiatrists and psychologists do a much better job. “We know that mental health is very important to our overall health, and we also know that folks with mental disorders or psychiatric disorders have a hard time accessing a good psychiatrist or psychologist. But now we’re seeing new tools, like your wearables on your clothes or on your wrist, or your smartphone, that can tell a lot about your mental state,” Kraft explained. These tools will gauge the tone of your voice and read your text messages and social media postings, and will alert the doctor—or the patient’s mother—if there are any signs of danger. “All these tools can, I think, be very helpful. I believe in digital psychiatry,” he said.
WE CAN ALREADY HAVE A 24/7 CONNECTION WITH OUR DOCTOR
Toward the end of our interview, I asked Kraft whether he himself has all his wearables and shockables directly connected with his doctor’s office. “That’s right,” he answered. Until recently, he used a health app on his phone that let him monitor all his vitals and that was also connected to his bathroom scale at home so he could see how much his weight varied over time, he told me. The app also tracked how many steps he walked, how many sets of stairs he climbed, and how many hours of sleep he got per day. But now all that information goes to his doctor as well, he added.
“About a year ago I was the only person who could look at that data, but now I can hit a button on my smartphone and connect that data with my medical records at my doctor’s office at Stanford,” he said. “So now data from my watch, from my bathroom scale, from my blood pressure cuff, from my glucose monitor (if I had one) can all flow to my doctor’s office. He can see that information, and if he needed to, he could use it to help guide therapy or help me manage my medications or other issues. All of this is just now starting to happen.”
Of course, doctors and nurses aren’t going to be glued to their screens tracking stats from each and every one of their patients, Kraft said. “But they’re going to use software like AI machine learning to understand what’s
relevant to each particular patient.” And as is the case in hospitals, doctors will get an alarm if there’s any imminent danger to a patient, or perhaps even a series of alarms, depending on the urgency of each particular case.
ADVICE FOR THOSE WHO WANT TO STUDY MEDICINE
Finally, I asked Kraft about what advice he might have for young people wanting to study medicine, considering the current technological threats to the profession. He responded that medical students will have to study much more than medicine, because medicine will become a much more interdisciplinary profession. Students will have to learn to work with scientists, data analysts, engineers, and other professionals who until recently had no place in a doctor’s office.
“I think it’s a really exciting time in medicine,” he said, “particularly for young folks who come from many different fields, and who will play a role in reshaping health care as we know it.” Even medical students who don’t simultaneously study other disciplines will have to be well versed in computer programming, data analysis, and genetics in order to work in the hospitals of the future. Others might want to study engineering so they can specialize in robotic surgeries, or so they can design, manufacture, and perfect devices that help elderly people get around better, or help those suffering from paralysis, as Hugh Herr of MIT has been doing. In other words, “it’s going to take people young and old from many different fields coming together,” Kraft concluded.
In the end, thanks to preventive care, data analysis, personalized home diagnoses, increased connectivity with our doctors, and virtual medical consultations, we will have to make fewer trips to the hospital or doctors’ offices in the future. To use a car-racing metaphor, hospitals will become like pit stops where drivers can pull in to have a wheel changed before getting back on the racetrack. Instead of going to the hospital for an emergency, we’ll periodically pop in for a quick tune-up and then get back out on the road of life.
DEEPAK CHOPRA: PHYSICIANS WILL HAVE TO EVOLVE INTO NEW PROFESSIONS
While writing this book, I also interviewed Dr. Deepak Chopra, the alternative medicine guru who is a staunch critic of traditional doctors’ habit to prescribe pills for almost everything. Considering his deep skepticism of traditional medicine and his penchant for ancient meditation and Ayurvedic practices, I expected Chopra to have a very negative view of the medical technologies supported by Kraft and other futurists. I had interviewed Chopra several times before, and he had always assured me that he didn’t take any sort of medication besides herbs and other natural products. He has always been very mistrustful of the pharmaceutical industry, so I was quite curious to hear what he would have to say about automated surgeons, microbots, and artificial intelligence to track and maintain our health.
Much to my surprise, Chopra didn’t lash out against the technological innovations that are revolutionizing modern medicine. “Technology is the next phase of human evolution, and it can’t be stopped,” he told me. “So if you resist the emergence or evolution of technology, you will become irrelevant.” Physicians will have to work with things such as vibrational therapies, ultrasonics, augmented reality, virtual reality, and artificial intelligence, “or they will be condemned to irrelevance. That’s the number one principle,” he said.
“Principle number two is that technology is neutral,” Chopra continued. We can use it to destroy the world or to improve it. “I see a world five years down the road where, instead of prescribing you a drug, a doctor will put you through a thirty-minute virtual reality or augmented reality session, after which you’ll feel better.” Or there could be brain wave technology and sleep training, and nanobots running through your blood vessels and cleaning out the plaque or suppressing genes that cause disease. “All of these things will be computerized and all regulating themselves,” he said.
So what will doctors do? I asked. “Just like everyone else, doctors will either adapt or become extinct,” Chopra replied. “I believe that the role of physicians, and health caretakers in general, will be more collective. Medical treatment will not be a one-to-one relationship anymore. It’s not going to be me consulting a doctor maybe once or twice a year…I will feed my information, and algorithms will come in and give me the best and latest treatments available. And then I can engage in a personal relationship with a caretaker, just to feel good.” Instead of a doctor-patient relationship, we’ll consult with groups of experts in all areas of health and wellness. We’ll have a lot of them, and they’ll all interact through technology to improve our health, help us sleep better, manage stress, or encourage exercise, he added.
“There will be a role for someone to hold your hand, and to be there in a very compassionate way, that we have lost already, to guide you through the process. But physicians as we see them today will become a lost species,” he concluded.
Chopra—who is prone to grandiose statements—is probably exaggerating a bit, but the fact is that medicine will quickly become a much more precise, personalized, participatory, preventive, and predictable profession. Certain specialists will be replaced by intelligent machines, and others will be working side by side with data analysts, geneticists, and robotic engineers. Doctors will continue to exist, but their primary mission will be to constantly monitor the information they receive from our sensors, interpret the data sent by our smartphone apps and home medical labs, help us select the best diets, medicines, and treatments recommended by intelligent machines, and give us practical advice and encouragement throughout the whole process. To put it in another way, doctors will cease to be repairmen for our diseased organs and instead become counselors on how to improve our health. Whatever you think of Chopra’s critical views of traditional medicine, he is absolutely right about one thing: doctors who don’t adapt to the new technologies will soon become irrelevant.
7
THEY’RE COMING FOR TEACHERS!
THE FUTURE OF EDUCATION
MIAMI
In a televised interview with Professor Einstein—the small humanoid robot with white hair, a thick walrus mustache, and the other unmistakable features of the Nobel Prize–winning physicist—it couldn’t have gone worse. Hanson Robotics, the company that created the robot, had just launched the promotional campaign for its new educational robot after having been granted a five-year license by the Hebrew University of Jerusalem to use the name of the famous physicist. According to the company, Professor Einstein would be the first of many robots that would revolutionize education by teaching students in a more fun, interactive, and effective way than human teachers do.
When I saw Professor Einstein on the screen—I was in a Miami TV studio, and he was in a New York studio—the just-over-one-foot-tall robot looked very funny. In addition to having an Einstein-like air of absent-minded professor or crazy genius, he could laugh, move his eyes in all directions, and even stick out his tongue. He walked and could make more than fifty facial expressions. The little robot was standing on a desk at the set in front of Andy Rifkin, the chief technology officer at Hanson Robotics. Before the start of the show, we had agreed that I would ask questions directly to Rifkin, who would relay them to Professor Einstein, because the robot was operating on a voice recognition program, and we didn’t want to run the risk of the robot’s not understanding me. According to Rifkin, Professor Einstein could recognize only familiar voices like his.
Rifkin began by explaining the advantages of his robot. Professor Einstein could describe the theory of relativity in a number of different ways depending on the strengths and weaknesses of each student, he told me. “All individuals are unique: some of us learn visually and others perceptively, so we’re constantly modifying the way we present a topic based on your personal way of learning. If Professor Einstein can’t get you to understand what he’s explaining, he’ll change the way in which he’s explaining it and keep trying until you understand,” Rifkin said.
But the interview quickly went downhill. No sooner had Rifk
in begun to discuss the advantages of Professor Einstein than the robot started swinging his head from side to side instead of looking directly at the camera. Visibly anxious, Rifkin started typing on his laptop in an attempt to return the robot to his original position. But the robot was still staring off to one side, as if he wasn’t interested in being interviewed at all. Noticing that something was going wrong on the other side, I stretched out my next question for as long as I could, trying to give Rifkin more time to straighten out his robot. Finally, I asked Rifkin to ask Professor Einstein what kinds of things he was able to do. Rifkin relayed the question, and the robot, still looking off to one side, responded in a rather robotic accent: “I can walk, talk, teach games, forecast weather, and answer all kinds of questions about science.” He finished up with a joke that fell a bit flat, since he still wasn’t looking into the camera: “In short, I’m your personal genius, or at least that’s what it says on the box.”
When I asked a follow-up question through Rifkin, the robot remained speechless. Several seconds passed, and Professor Einstein still didn’t react. Rifkin—visibly nervous—asked him the question again, but now the professor was silent and expressionless, as if absorbed in his own thoughts. After a number of failed attempts to interact, Rifkin explained on the air that the robot had probably been muted because the Wi-Fi connection had gone down. With the cameras still rolling, I jokingly suggested that Professor Einstein probably had a case of stage fright because this was his first live television interview, and we cut to a commercial break. After several more attempts, we were finally able to resuscitate the robot, and it told us a little bit more about the things it was able to do.
The Robots Are Coming! Page 22