Electronic Health Reporter

Ah, venture capitalists. You’ve got to love them. They insert themselves into a variety of topics and industries they know nothing about and pretend they can make everything better about whatever industry they ingest.

I worked for a VC-owned health IT firm for a few months following the sale of a division of a public company. What followed is round after round of layoffs, reduced investment into the product and cuts everywhere something could be cut.

But, I’m a capitalist at heart so I can’t really blame them. They’re out to make money. So am I.

But, what I find it somewhat ironic is that a VC is telling the world that in the near future, nearly 80 percent of what physicians do will be replaced by computers. What’s crazier, at least as far as I’m concerned is that he’s right, if not in whole at least in part.

According to Vinod Khosla is the founder of Khosla Ventures, “Much of what physicians do (checkups, testing, diagnosis, prescription, behavior modification, etc.) can be done better by sensors, passive and active data collection, and analytics. But, doctors aren’t supposed to just measure. They’re supposed to consume all that data, consider it in context of the latest medical findings and the patient’s history, and figure out if something’s wrong. Computers can take on much of that diagnosis and treatment and even do these functions better than the average doctor (while considering more options and making fewer errors). Most doctors couldn’t possibly read and digest all of the latest 5,000 research articles on heart disease. And, most of the average doctor’s medical knowledge is from when they were in medical school, while cognitive limitations prevent them from remembering the 10,000+ diseases humans can get.”

He continues: “Computers are better at organizing and recalling complex information than a hotshot Harvard MD. They’re also better at integrating and balancing considerations of patient symptoms, history, demeanor, environmental factors, and population management guidelines than the average physician. Besides, 50 percent of MDs are below average. Computers also have much lower error rates. Shouldn’t we take advantage of that when it comes to our health?!”

Perhaps what’s most intriguing about his argument is that is just makes sense. By automating the process and reducing the redundancies and inefficiencies, physicians can focus more on the relationship they need to build with their patients. Khosla says in his Fortune piece, that automating healthcare improves relationships. “Providing good bedside manner and answering certain questions can often be handled better by a person than a machine, but you generally don’t need a medical degree to do that.

Nurses, nurse practitioners, social workers, and other less expensive, non-MD caregivers could do this just as well as doctors (if not better) and spend more time providing personal, compassionate care.”

Finally, what may be his most bulletproof part of the argument is that a transition to automation is happening in several other markets or areas that are worthy of taking note of. For example (and I’m citing directly):

• Most commercial flying is now done by auto-pilot, not by the captain. Algorithmic trading now drives most stock market volume.
• Google’s (GOOG) self-driving car has had zero accidents driving 300,000 miles on normal streets. The same replacement of human involvement by computers will also happen in healthcare.

Because of automation, physicians supposedly will have more time to spend talking to their patients, making sure they understand, and “finding out the harder-to-measure pieces of information because they’ll spend less time gathering data and referring to old notes. And, they will be able to handle many more patients, reducing costs.”

The last point may be a bit of a stretch. I’m not sure any amount of automation can actually reduce costs.

But here’s the heart of the story, the heart of the entire current healthcare story: Where will the innovation come from.

“Innovation seldom happens from the inside because existing incentives are usually set up to discourage disruption. Pharma companies push marginally different drugs instead of potentially better generic solutions because they want you to be a drug subscriber and generate recurring revenue for as long as possible. Medical device manufacturers don’t want to cannibalize sales of their expensive equipment by providing cheaper, more accessible monitoring devices. The traditional players will lobby/goad/pay/intimidate doctors and regulators to reject innovation. Expecting the medical establishment to do anything different is expecting them to reduce their own profits. Granted, these are generalizations and there are many great and ethical doctors and organizations.”

Well put, Mr. Khosla!

What’s going to change it? People in need. Entrepreneurs. Those looking to innovate. Those looking to capitalize. VCs…