The Top Medical Specialties with the Biggest Potential in the Future

Some say technology will replace 80% of doctors in the future. I disagree. Instead, technology will finally allow doctors to focus on what makes them good physicians: treating patients and innovating, while automation does the repetitive part of the work. While every specialty will benefit from digital health, some will especially thrive due to these innovations. Here, we enlisted the medical fields with the biggest potential for development in the future.

No More Repetition – Doctors of the Future Will Treat and Innovate

Artificial intelligence, wearable sensors, virtual reality, medical robots – these disruptive technologies are completely changing the way patients and doctors think and act about healthcare. Silicon Valley investor Vinod Khosla once said that technology would replace 80 percent of doctors in the future because machines will be more accurate, objective and cheaper than the average doctor. We would not need doctors at all eventually, he added.

I disagree. Instead, technology in some specialties will finally allow doctors to focus on what makes them good physicians: treating patients and innovating, while automation will do the repetitive part of the work.

While digital health already has a huge impact on the way doctors work, it clearly matters a lot what kind of tasks we allow them to take over. There are many repetitive and monotonous tasks which most medical professionals hate to do, while digital health solutions can do it better, faster and cheaper. These tasks usually do not contain any creativity or empathy. I would say the human touch is missing completely. Digital health should replace such responsibilities. Yet, as healthcare is not a linear process where an input leads inevitably to the wished output, there is a bigger need for the creativity and unique problem-solving skills of doctors than ever. These are the skills no digital health device or software can and will replace.

So, the process of digital technology coming into healthcare is more complex than just saying AI or robotics will take over jobs. As with other fields of innovation, there will be areas or jobs which will be more affected than others, there will be specialties that will thrive more than others. Here you find at least ten medical specialties which will benefit from the technological revolution.

1) General practice

Many doctors choose this specialty today to make a long-term impact on someone’s life. And it is true: GPs enjoy tremendous trust from their patients. But seeing someone only when they are feeling sick makes it difficult to prevent disease and ensure someone’s well-being. It is even harder to do so when waiting rooms are overcrowded, and you only have a few minutes to diagnose illness, design a therapy and offer health advice.

Wearable sensors and devices that stream data to a doctor’s smartphone, notifying them whenever vital signs are acting up will provide them with all the necessary data for providing care. These will also ensure doctors only treat those who really need professional care, making it possible to offer simple treatment advice remotely. In turn, this will increase the time GPs have to treat and advise each patient, building trust and ensuring patients act on the doctor’s advice. What’s more, smart algorithms will ensure the GP can tap expert advice on rare disease and act as a gatekeeper to other specialties.

Digital health assistants and medical chatbots could also significantly ease the burden on GPs. In the future, patients could turn to chatbots with simpler questions about their health, about certain drugs or manage their administrative matters. The UK’s National Health Service (NHS) already recognized the potential in chatbots: they will start to use a chatbot app for dispensing medical advice for a trial period in 2017 to mitigate the pressure on its 111 non-emergency helplines. The NHS is developing the app with Babylon Health, one of the new breed of paid, doctor-on-demand services. Also, bots like HealthTap or Your.Md, aim to help patients find a solution to the most common symptoms through AI.

2) Pediatrics

Pediatrics today have a very limited window of time for assessing the status and health of a baby or the pregnant mother. Wearable devices that monitor the mother’s and the child’s vital signs will ensure that in the case of an emergency, delivering care will not depend on the mother’s luck.

Though from an ethical point of view it is a very controversial area, cheap genome sequencing from the mother’s blood and genome editing methods like CRISPR might well make it possible for pediatricians to correct any genetic conditions in utero. It might also lead to designer babies. With the same method, cheap whole-genome sequencing, pediatricians could also access a vast amount of data to diagnose and treat children.

3) Radiology

Deep learning algorithms and narrow AI started to buzz around the field of medical imaging lately, and many radiologists went into panic mode. From the discourse around them, they got the idea that AI will replace radiologists soon. Yet, I rather believe that AI will augment their jobs and free them from plenty of their monotonous and repetitive tasks. Radiologists’ future will be much more exciting than checking hundreds of X-rays a day.

For example, IBM launched an algorithm called Medical Sieve qualified to assist in clinical decision making in radiology and cardiology. It can scan hundreds of radiology images in seconds; and it is able to find easily recognizable malignant or out of place phenomena, while radiologists can deal with the complex cases and difficult issues.

And we are not far from the close cooperation of AI and radiology in clinical practice. The FDA approved the first cloud-based deep learning algorithm for cardiac imaging developed by Arterys in 2017. According to some estimations, within 3 years we’ll have many machine learning algorithms in active clinical pilot testing and in approved use. Bradley Erickson, Director of the Radiology Informatics Lab at Mayo Clinic told me that although it is not likely that AI would create preliminary radiology reports about its screenings for everything in 10 years, there is a pretty good chance it will do it in certain fields. How exciting does that sound?

4) Ophthalmology

This specialty will bring science fiction technologies to patients in the near future. Retinal implants might give vision back to those who lost it or grant humans supervision augmenting what we can do. Digital contact lenses could transform both how we look at the world while also revolutionizing certain areas such as diabetes care. For example, Google teamed up with Novartis, to produce digital, multi-sensor contact lenses which is designed to be able to measure blood sugar levels.

Google and Novartis said the lens would contain a tiny and ultra slim microchip that would be embedded in one of its thin concave sides. Through its equally tiny antenna, it would send data about the glucose measurements from the user’s tears to his or her paired smartphone via installed software. Originally, the companies promised to put the digital contact lens around 2020 on the market, but Novartis Chief Executive Joe Jimenez in 2015 said that the contact lens would be on track to begin testing that year – and backtracked later.

Since then, there has been no news about the state of progress. However, in March 2017 Novartis Chairman Joerg Reinhardt talked down the chances of the project bringing visible results in the next couple of years.

Also, cheap smartphone-connected sensors and apps that use the phone’s camera can help in diagnosing eye conditions even in under-developed regions.

5) Sports medicine and rehabilitation

The first swarm of activity trackers focused completely on people who exercise regularly, but only provided basic insight into how they were performing. Now, a new generation of devices tailored to professional athletes is hitting the market like Fitbit Blaze, GymWatch, and Wahoo. With detailed insight into movement patterns and force output in any movement, sports medicine physicians will have concrete data to measure how athletes are improving. Also, video consoles from XBox to Microsoft Kinect offer a way of monitoring how the patient is doing from a distance by seeing their progress literally on screen.

But wearables are only the tip of the iceberg. Look at the amazing exoskeletons! These external skeleton-like devices support and protect the human body from the outside. They let paralyzed people walk, and help the rehabilitation of stroke or spinal cord injury patients. Exoskeletons can also enhance strength so that they allow nurses to lift elderly patients.

Moreover, the Nova Scotia-based performance company, Athletigen Technology Inc. works with several athletes aiming to use their collected DNA information to improve performance, health, and safety. These genetic tests could reveal additional insight from a heightened risk of injury until nutritional demands. Later, these results allow the helpers of an athlete to adjust his or her workout plan and nutrition accordingly.

6) Oncology

This specialty will pave the way for precision medicine and targeted treatments. Oncologists already customize therapies based on patients’ genetic background and their tumors’ molecular makeup. Cheaper genome sequencing and measuring blood biomarkers are speeding up this process. Companies like the spin-off venture of Illumina called GRAIL are developing fluid biopsies. These are blood tests able to detect all types of cancer from a very early stage. By being able to filter tumor cells from blood samples, doctors could soon diagnose and analyze tumors earlier and without costly surgery.

Tech giants, such as IBM, Google, and Microsoft, as well as a series of start-ups, such as the Hungarian Turbine, are building artificial intelligence solutions to design personalized treatments for any cancer type or patient faster than any traditional healthcare service. In the case of IBM, they launched Watson for Oncology to help cancer research; Google has its Deepmind Health project; while Microsoft’s research machine-learning project, dubbed Hanover, aims to ingest all the papers and help predict which drugs and which combinations are the most effective.

7) Dermatology

Our skin functions as a litmus test for our health. You see the passing of time, the amount of sleep or the signs of stress on it. As you can easily see if you have a skin problem, and smartphones coupled with super fast internet connection make it easy to send pictures or footage anywhere, telehealth solutions are coming to dermatology. For example, with idoc24.com, patients already have the chance to send pictures about rashes, lesions or weird spots they are concerned about, while dermatologists can give them medical advice in 24 hours online. It is a win-win for everyone: patients do not have to wait in crowded waiting rooms for an exam, while dermatologists can deal with the easier cases in shorter time online. Moreover, IBM decided to let dermatologists leverage on the results of its deep learning platform, Watson in order to diagnose melanoma and other types of skin cancer faster, more accurate and preferably without the need for many biopsies. At the IBM T.J. Watson Research Center, experts found that their deep learning system was able to achieve a 76% accuracy at diagnosing melanoma cases based on dermatology images, while the average accuracy for the eight dermatologists on that data set was 70.5%. It is a very promising result! Imagine how much AI could help in diagnosing skin cancer in the future!

Moreover, amazing high-tech machines also come to the rescue! The New Jersey-based company, Canfield Scientific have recently installed the first commercial Vectra WB360 whole-body skin lesion mapping system. It is able to take a 360-degree scan of the entire body and identifies all the lesions on the skin. Mind-blowing!

And how can digital health help people who suffered burn injuries or have other permanent skin issues in the future? James Yoo at the Wake Forest School of Medicine in the US, as well as researchers at the University of Madrid, have developed the prototype of a 3D printer that can create synthetic skin. It is adequate for transplanting to patients, and may also be used in research or the testing of cosmetic, chemical, and pharmaceutical products.

8) Emergency Medicine

There are situations when time is crucial, for example in the case of disasters or medical emergencies. These require urgent responses, so any innovation aiming to help this specialty should shorten the time required for reaching the scene of unfortunate happenings. Medical drones have great potential in making the transport of drugs, vaccines or medical aids faster.

Google, the tech giant with a significant medical portfolio, patented a device that can call for a drone in emergency situations to fly in with life-saving medical equipment on board. You would push a button, and a drone would appear on the spot. How amazing does that sound? And what about drones deliver automatic external defibrillators (AEDs) directly to people who have just suffered a heart attack? Researchers from the University of Toronto are already experimenting with the idea based on their inspiration from ambulance drones in the Netherlands.

With the development of handheld devices and sensors, it will also be easier to assess patients wherever they are. Eric Topol, an eminent cardiologist and digital health pioneer was flying home from Washington DC once when severe chest pains crippled a fellow passenger. Topol reached for his iPhone encased in a special FDA-approved cover made by AliveCor. It can record users’ heart rate and ECG through their fingertips and transmits the results to an app. Topol placed the AliveCor case on the man’s chest. It showed he was having a heart attack. The plane made an emergency landing, and the passenger survived. This is how portable diagnostic devices such as AliveCor, CliniCloud or Viatom Checkme Pro will make patients the point-of-care in the future.

Don’t forget driverless ambulances that could leave medical professionals on board focus entirely on the patient.

9) Gastroenterology

This branch of medicine is focused on the digestive system and its disorders, so they really want to see what’s going on inside your belly in order to help you. Until recently, it was very circumstantial to look around in the stomach or the gastrointestinal tract, but nanotechnology will help a lot in the future. What if physicians had a way to see inside a patient’s GI tract by having them simply swallowing a pill-sized camera? It is already possible with the innovation called PillCam. More than 1.5 million patients have already experienced the benefits of this so-called capsule endoscopy. Physicians can now visualize the small bowel, esophagus, and colon with a small, disposable capsule used to monitor and diagnose disorders of the gastrointestinal tract without sedation or invasive endoscopic procedures. I hope that this practice will spread around hospitals very soon!

At the Cedars-Sinai Medical Center, there is also the possibility for patients suffering from inflammatory bowel disease (IBD) to take an active part in figuring out how to treat them best. An online platform allows them to go through a so-called Decision Tree; which shows different medicine profiles and allows patients to decide which ones they would consider using.

10) Infectious diseases

The WHO reported that 53 countries reported evidence of mosquito-borne Zika virus transmission since 2015. It causes tremendous effort to somehow mitigate the effect of the epidemic. In Western Africa, between 2014-2016 the spread of the Ebola virus resulted in more than 10,000 death and almost 30,000 people were infected with the deadly disease. Although the epidemic seems to be over, you never know when the virus will reappear. Also, as a downside of globalization, infections can be transmitted to other parts of the world very quickly. Thus, we have to prepare for the coming epidemics in advance and do everything in order to prevent their spread. Early in March, IBM announced a partnership with public health agencies to help Taiwan and Panama battle the Zika virus and the dengue fever. In the latter case, the aim of computer modeling is to predict the effectiveness of intervention methods. Moreover, the US Center for Disease Control is using geographic information systems integrating data from several sources to track and better combat the Zika virus.

Several organizations noticed that the wearable technology can also be utilized for preventing epidemics or providing an early response. There are pilot studies aimed around supplementing stretched care in West Africa by remotely monitoring vital signs via mobile Health technologies. Sensors are able to monitor early changes in any patient’s status and alert caretakers allowing them more time to respond. As in the developing world, the number one communication device is the mobile phone, the Red Cross in Haiti decided to use this platform to bring life-saving information to millions of Haitians. While it seems to be a simple idea, it could easily save thousands of lives. The Red Cross has embarked on a nationwide malaria prevention campaign; sending over 3.5 million SMS messages which include information on how malaria is transmitted, how to recognize the symptoms, treatment options, and simple steps for prevention. A brilliant method for raising awareness!

11) Surgery

Surgery will become a lot more data-driven, robotic and artificially intelligent in the future. Digital health offers an amazing cooperation between humans and technology, which could elevate the level of precision and efficiency of surgeries so high we have never seen before. There are already signs how digital technologies are gradually taking their place at the operating table. According to market analysis, the surgical robotics industry is about to boom. By 2020, surgical robotics sales are expected to almost double to $6.4 billion. The most commonly known surgical robot is the da Vinci Surgical System featuring a magnified 3D high-definition vision system and tiny wristed instruments that bend and rotate far greater than the human hand. The surgeon is 100% in control of the robotic system at all times; he or she is able to carry out more precise operations than previously thought possible. Not only robotics but also 3D-printing, augmented reality or virtual reality help surgeons with complex operations or complicated cases – especially in the preparation phase. In March 2016 in China, a team of experienced doctors decided to build a full-sized model of the heart of a small baby born with a heart defect. In December 2016, in the United Arab Emirates doctors have used 3D printing technology for the first time to help safely remove a cancerous tumor from a 42-year-old woman’s kidney. I believe surgeons have to rethink their working methods for the future and let digital technologies be part of their profession more in order to being able to deliver more precise operations with less harm. It will be a double jackpot for patients!

More Time for Patients and Better Insight into Disease

All in all, many jobs will be taken over by robots and automation in the coming years. But awesome opportunities will also emerge, especially in medicine. Physicians need to acquire new skills and improve their existing ones. In many specialties, physicians will have more time for patients and better insight into diseases. Thus, it is up to each of us to hone our skills and make ourselves irreplaceable in this brave, disruptive new world of healthcare.

Fonte: The Medical Futurist

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