Dennis Gabor won the Nobel Prize for Physics in 1971 after a lifetime developing, studying, and expanding the world’s knowledge of the sciences and holography. His work as an inventor, communicator and theoretician changed the world—and our global concepts of what’s possible.
During many of the darkest days of the 20th century, he tackled some of the universe’s toughest challenges with eyes firmly set on tomorrow. He survived enlistment during World War I, fled the Nazis ahead of World War II, and remade his life with a foreign language in a foreign land. The industrial world had presented both challenges and opportunities, and Dennis Gabor was a futurist.
“We are still the masters of our fate,” Gabor wrote in 1963. “Rational thinking, even assisted by any conceivable electronic computers, cannot predict the future. All it can do is to map out the probability space as it appears at the present and which will be different tomorrow when one of the infinity of possible states will have materialized. Technological and social inventions are broadening this probability space all the time; it is now incomparably larger than it was before the industrial revolution—for good or for evil.”
“The future cannot be predicted, but futures can be invented.”
We’re all inventors.
What kind of future are we going to create?
The 21st century will present different challenges than those confronted by Gabor and his peers, but there will be new opportunities as well. Health care is revolutionizing our quality of life, how long we live, and how we consume information. Its role in scientific, political, and broader popular culture have thrust physicians into the roles of advisors, guides, and statesmen.
On a daily basis, physicians are inventing new technologies and approaches to improving, protecting, and restoring the human body—and shaping our tomorrows. That’s no small responsibility.
The Future of Medicine
The practice of medicine has changed substantially in recent years, due to rapidly changing technologies, fresh research, and a renewed focus on racial equity and the social determinants of health (SDOH). As Michigan physicians and caregivers work to address these transformations, there’s never been a better time for us to look ahead and determine what kind of health care future Michigan’s physician leaders are working to build.
Last year, the Michigan State Medical Society invited Lansing-based Public Sector Consultants to conduct interviews with health care leaders, with a focus on physician voices, to gather input on the most pressing issues in health care, how to address those issues, and the policies needed to support those changes. The Society also investigated opportunities to support Michigan physicians and improve health care over the coming years.
Researchers found physicians in Michigan already imaging a future designed to deliver better results for patients. The future of health care is in capable hands, and they’re hard at work.
Public Sector Consultants is a local organization that’s served hundreds of government agencies, nonprofits, associations, and industries for more than 40 years. They’ve built a reputation in Lansing as non-partisan, no-nonsense investigators who can cut through the clutter and deliver results.
PSC compiled their findings in a new report called The Future of Medicine, available now free for physicians at MSMS.org.
As one might imagine, their research identified roadmaps Michigan’s physician community are following—and carving out of the wilderness of the health care universe.
Physicians and health policy experts identified hundreds of unique threads being woven into the fabric of better patient care.
A meta-analysis of the data found
seven major themes and finding:
• Inventing the Future of Medicine
• Key Findings and Major Themes
• Team-based and integrated care models
• Multidisciplinary and cross-sector collaboration
• Value-based and risk-based contracting
• Electronic health record improvements
• Social determinants of health and health equity
• Payer alignment and transparency
Physicians are building a future based on team-based and integrated care models, because collaboration delivers the best outcomes.
That includes multidisciplinary and cross-sector collaboration that expands the team. Health insurers, pharmaceutical purchasers, Michigan businesses and patients themselves all have a role to play on the team.
Value-based and risk-based contracting, health care leaders told researchers, decreases variability in care and leads to better results.
They’re also leading the charge to put more information in the hands of patients and their providers. Electronic health record (EHR) improvements will support clinical decision-making when it comes to diagnosing challenges and identifying the best evidence-based treatments. Interoperability will take the team dynamic to the next level, allowing providers in different practices, health systems, and locations to pull together in the same direction.
Payer alignment and transparency, experts said, is about a lot more than accounting and paying the bills. It’s about reducing administrative burdens, reducing prior authorization requests, and putting physicians back alongside patients instead of stuck behind a desk.
Physicians are also tackling opportunities to better identify and address social determinants of health and health equity.
Tying the entire effort together, researchers claim, is expanding physician leadership. The last two years have driven home the key role physicians play in the health and wellness of their patients and their broader communities. There’s a trust factor between a doctor and his or her patient that can save a life. Building that trust within health systems, physician organizations, with payers, and even on the public policy battlefield represents a challenge and an opportunity to improve patient outcomes on a broader scale.
Physician leadership can accomplish a lot—and that’s a lot of responsibility.
Thomas J. Veverka, M.D. is a general surgeon practicing in Midland, Michigan, and the President-elect of the Michigan State Medical Society. A member of the board of the Michigan Health Improvement Alliance and a member of clinical faculty at both Michigan State University and Central Michigan University, Doctor Veverka’s work places him smack-dab in the middle of the physician efforts to build a better future.
“As leaders and advocates, it is incumbent upon all of us to spend time with these findings,” said Dr. Veverka. “Ultimately, it is our work with one another and with MSMS that will help us achieve the results we want for our patients and our practices. We’ve identified the battle plan for a much healthier Michigan. Now it’s time to do the hard work one patient, one practice, and one conversation at a time to build it.”
Michigan’s health care leaders are already on the job.
Team-based and Integrated Care Models
Public Sector Consultants’ central finding, after consultation with nearly 60 health care leaders from across the state, should come as great comfort but no surprise. Physicians view the future of medicine through the lens of better patient outcomes.
“We will continue to be in the business of treating patients; medicine may be pulled in different directions—public health, advocacy—but it all comes back to treating patients,” one Michigan provider told researchers. “We need to recapture the fundamental nature of what medicine is about and for—treating people and staying patient centered.”
Patients’ future will be brightest through the development and enhancement of team-based and integrated care models. Contributors expressed broad support for these physician-led models, which allow practices to address their patients’ needs more holistically while allowing everyone on the team to practice at the top of their license.
Working together, patients gain access to the right provider—and the right part of the team—at the right time. It’s an approach that also focuses the entire team on delivering the best patient outcomes. The physician remains accountable, and everyone on her or his team remains responsible.
Integrating that care across settings, leaders told researchers, means a focus on prevention, stronger relationships between patients and providers, and better identifying challenges outside a single provider’s specialty—especially challenges that may impact a patient’s broader care.
Breaking down barriers between treating physical and behavioral health issues separately and tying in challenge resolution with preventative care can make a world of difference for patients. It can save a life.
Michigan physicians recognize that, and they’re building those bridges.
Multidisciplinary and Cross-Sector Collaboration
Stronger working relationships and communications among physicians and between a physician and his or her health care team are identifying challenges and opportunities faster than ever before. A focus in the coming years on stronger multidisciplinary and cross-sector collaboration will send that progress through the roof.
Physicians and other health care providers need to work directly with payers, experts told PSC. Payers. Purchasers. Businesses. Patients. Each plays a unique role in public and private health.
“In our practice, we have really driven hard to build a multidisciplinary team: social work, behavioral health, care management, and quality experts built into infrastructure in our clinic,” one Michigan provider told researchers. “We need a whole lot more of that. If we’re going to adopt new models, we need to reach outside the (practice or) clinic.
“The practice model of the future is community integrated. Live, direct communications with multiple philanthropies so we can drive grants into areas that need it. Engaging with local political leaders. Liaisons with grocery stores and work with grocers to identify food deserts to champion and actively politicize the need for transformational change.”
When patients have access to housing, food, and clean water, they’ll encounter fewer health challenges. Collaborating with community organizations to improve access to those services isn’t providing something “extra.” It’s often a critical first step.
Value-based and Risk-based Contracting
Better health for Michigan patients also means an evolution toward value-based and risk-based contracting, according to researchers. It’s an approach that helps decrease variability in care and get patients the biggest bang for the health care buck.
Focusing on value-based contracting would have an added benefit—more providers in family practice, where care is so often desperately needed.
“The payment model has to move,” providers told PSC. “If we build one that benefits patients, it will support physicians too. It needs to incentivize value and addressing the social needs of patients and have the infrastructure to do so, too.”
EHR Improvements
Patients, of course, value control over their health care experience, and access to the diagnoses, test results, and battle plans their providers identify.
Again and again, Michigan physicians told researchers that they’re fighting for a future that puts health care information and electronic health records in the hands of their patients—and their peers in other settings and specialties.
“Everything already exists for universal electronic health records and marrying that with artificial-intelligence enhanced decision support,” one provider said, borrowing an approach from futurists like Dennis Gabor. “It’s already out there, we just have to implement it. Leveraging these tools will hardwire best practices and evidence-based guidelines to immediately improve quality (of care).”
It’s an approach that would also allow patients to have a better say and a bigger stake in the management of their own health care. It’s time to put those tools in the hands of patients and providers alike.
Social Determinants of Health and Health Equity
Health care leaders often pointed researchers to the ways proposed advancements to practice models, payment models, and technology would also enable medicine to better identify and address social determinants of health and health disparities. It was a concern of providers in every part of the state.
“We need a more personalized approach to medical care that is individualized for patients, where patients and providers work together with patients as the driver of their medical care, including in addressing social determinants of health and behavioral health needs,” one physician leader said.
Whether it’s a history of smoking or a family home located in a food desert, physicians recognize the path to a healthier future means better understanding the patients they’re walking alongside.
They told researchers that means identifying patient needs through a conversation, assessments, and better knowledge of available resources and how to connect those resources to those patients. It’s the kind of support that’s best and most effectively delivered through a team-based care model. Sometimes that may even mean including a social worker or care manager who are expertly suited and trained to support patients in addressing their social service needs.
Michigan physicians are leading the charge with an approach that’s deeper than a questionnaire and an exam, because prioritizing patients means creative and more holistic thinking.
Payer Alignment and Transparency
Too often, still, paperwork and payers stand in the way of the best and most timely care.
Physician leaders identified improvements in payer alignment, transparency, and additional simplification of prior authorization processes as central features of health care’s future. They’re going to bat for patients at their practices, and with payers, too.
Better alignment among payers regarding the metrics they use to monitor quality of care. More transparency surrounding payment models they use to incentivize value-based care. Fewer hoops to jump through to get patients access to the treatment and medicine they need to overcome a challenge or live a healthier life.
They’re the kind of fixes physicians have the least control over, but that hasn’t stopped them from using their voice or identifying the path to a healthier future.
Fixes would reduce administrative burdens, they’d hasten care, they’d keep physicians in the exam room and operating suites instead of behind their desks, and they’d lower costs for patients and payers.
Clearing bureaucratic hurtles outside the world of providers has never been easy, though, but Michigan’s health care leaders refuse to shrink from the challenge.
Physician Leadership
The pandemic’s taught us the need for physician leadership is critical both amongst their patient populations and in the broader public policy world.
Their voice in health systems, physician organizations, with payers, and with policymakers makes a huge and lasting difference.
“No one understand the needs of the patients and the resources available to meet those needs as well as physicians,” one respondent told researchers. “I don’t think anyone understand the opportunities for waste reduction and cost reduction as well as physicians. No one has a leadership perspective both within health care and in politics like physicians have. It is a unique perspective.”
The stakes couldn’t be higher. We’re only talking about the future.
When Vincent Gabor invented holography, he created a new way to look at the world. He ushered in a revolution that’s benefited patients and physicians around the globe.
X-ray holography is used for imaging of internal parts of the body and living biological specimens. It’s used for biomedical measurements. Noncontact high resolution 3D imaging and nondestructive measurements of internal organs has become possible, impacting endoscopic and other medicine.
The list goes on and on. Prakash Mehta writing for Integraf, a holographic supply expert serving providers in 55 countries, has identified and dissected the evolution of Gabor’s work in ophthalmology, dentistry, otology, orthopedics and so much more.
Gabor’s work was ahead of its time and his wisdom, timeless. The Governor of Illinois in a major speech even recently misattributed the physicist’s quotes to former President Abraham Lincoln.
His legacy, though, is carried by physician leaders across the state of Michigan and around the world. The future of medicine is dynamic, it’s revolutionary, and at the same time it’s incredibly simple. It’s about what medicine’s always been about—patients.
Let’s get building.
Readers can now review Public Sector Consultants full report on the Future of Medicine online at www.MSMS.org.
