The CEO of the American Medical Association jumped into hot water — or maybe a burning cauldron — this month when he slammed a wide range of digital health products as a dystopian pit of “snake oil."
Speaking at the AMA's annual meeting, James Madara, M.D. exhorted doctors to take up, once again, their historic role as guardians of reason over hype. He complained about everything from “ineffective electronic health records to an explosion of direct-to-consumer digital health products to apps of mixed quality," calling them "digital snake oil of the early 21st century," he said.
The reaction was swift and predictable.
Bryan Vartabedian, M.D., the foremost advocate for physicians engaging in public conversation through social media, flogged Madara and the AMA by citing the principle that "institutions will work to preserve the problem to which they are the solution."
John Halamka, M.D., the CIO of Beth Israel Deaconess Medical Center, also rejected Madara's argument, writing that “there is no snake oil. We created the digital foundation that is a prerequisite for the next generation of tools."
So, here we go again. All of us involved in practicing healthcare, writing about healthcare, or caring about healthcare are doing the two things we do best — ignoring the future and blaming each other for our failures.
Because, in a way, Madara is right. There are way too many apps to make sense of, and many seem to have the sole purpose of enriching a new group of 20-year-old entrepreneurs. On the other hand, as Vartabadian intimated, imagining that healthcare will continue to escape the consumer revolution is akin to Blockbuster believing entertainment would always involve people going to a store to pick up and return physical media.
As CEO of an almost-200-year-old institution that has finally decided to stop acting its age, I'm here to say that it's time for all of us to change the game. We need to give up the usual whack-a-mole of favorite targets — the AMA, the government, insurance companies, pharmaceutical companies, doctors, hospitals, and non-compliant patients — and stop pointing fingers at one another.
We have to recognize that we all overestimate technology in the short term by getting too excited about the latest app. But in the long run, we equally underestimate the power of technology.
Consumer technology, as Madara noted in his talk, has transformed every part of our lives except our lives as patients. But it will transform the patient experience, too — as soon as provider organizations own it, stop waiting for others to tell us what's cool, and start to view these technologies the same way we'd look at a revolutionary new imaging technique.
Sadly, the Madara melee makes it hard to imagine we'll stop playing the blame game anytime soon. By the same token, our patients in their 20s will keep pushing ahead with their mobile, digital-native lifestyles, leaving most healthcare institutions looking like the next Blockbuster.
Do you really believe that in the age of Instacart, Tinder, AirBnB, Snapchat, Instagram, and Uber, younger patients will abandon their mobile devices for the privilege of calling us to schedule an appointment (but only after navigating a labyrinth phone tree menu)? Or that they'll open a piece of snail mail to learn their lab results? Or wait in a waiting room? Or wait two weeks for an appointment on any day other than Saturday or Sunday? Or expect to use vacation time during work hours to have all of their health concerns addressed?
So let's use this as a wake-up call, for all of us responsible for caring for a population that will have infinite needs but finite resources. Let's recognize that the debate over the value of virtual health versus traditional health will be laughable five years from now, and start utilizing our collective health system resources to address the new reality: If you are in the healthcare business, you are now competing in a consumer dominant world.
In the early 2000s, it became clear to a few visionary people that computer companies would need to become digital companies. The revolution started with a tiny little thing called an iPod, which could store a few hundred songs. The reaction of some to Apple's “revolutionary idea" would make the reaction to Madara's AMA speech look tame.
But that big idea — that our lives would be more mobile, and more digital — took that little iPod and evolved it into an ecosystem of apps.
As physicians and healthcare leaders, let's not underestimate digital health, but let's also refuse to be satisfied with what exists in digital health today. It's far better for our professional societies, health systems and entrepreneurs to work together to lead a healthy and connected future for physicians and patients.
And if you're still exercised over Madara's comments? Chill out and download some Enya on your Apple Music server.
Stephen K. Klasko, M.D., MBA, is President and CEO of Thomas Jefferson University and Jefferson Health. He is author of the new book, “We CAN Fix Healthcare in America."