The Tipping Point

This post  on the BBC health webpage by the excellent @nicktriggle explains the concept of 'healthy life expectancy'.  I was very surprised that this is actually formally measured. I suppose one should not be surprised when GDP and pension projections depend on the number of healthy older people who can make a contribution to the economy. The converse is also true. Even though lifestyles may be getting worse in some quarters with obesity and alcohol intake on the increase, drugs and other health interventions are lengthening lifespans irrespective of lifestyle. As a cardiac surgeon, I have noticed in recent years the increase in the number of premenopausal women who have been admitted with myocardial infarcts or heart attacks and referred for urgent coronary bypass surgery.  Invariably they are very overweight and heavy smokers.
A sharp rise in the number of unhealthy elderly people represents a demographic nightmare for health services around the world - non productive and big scale consumers of welfare and healthcare services.
For years, much has been written and said about the dangers of obesity, smoking and heavy drinking. And yet it always seemed as if these changes represented clear dangers to society at some point in the future - well the future is here now and we have reached a tipping point.
Who is it who predicted that we do not need as many hospital beds in the future?  Dive back into your crystal ball mystic Meg! I suspect that the type of facility required to deal with the surge of unhealthy elderly has not yet been invented. 

The Democratizing Forces that will shape the Future of Healthcare.

Patient-centred healthcare, social media and the internet: the perfect storm? -- Rozenblum and Bates -- BMJ Quality and Safety

This is article is a great read and explains to a certain extent the forces that will shape the future of healthcare - determined by patients and consumers  - a truly democratic future whether doctors or managers or politicians like it or not!

When Surgeons lead.

This article published recently in JAMA surgery describes how in the US, surgeons are often taking the lead when it comes to healthcare reform. It gives excellent examples of how they are achieving this.  It also interestingly explains the circumstances why surgeons end up taking the lead - and it is not just because we are all dynamic go getters by nature!!

The Royal Colleges of Surgeons could do worse than emulating many of the initiatives shown by our colleagues across the water. In his defence, the current President of the English college, Professor Norman Williams, seems to get it and understands the opportunity that healthcare reforms in the UK presents to the surgical community. 

What however is really needed to save the world of healthcare is for primary care doctors to seize the moment - and that I suppose is where in the UK the private sector sees its role over the next few years  - to transform primary care in fundamental &  innovative ways so as to cure problems further down (or is it up) stream. 

The Future of Healthcare is the Smartphone.

There are divergent views of how, going forwards (uugh!!) healthcare will evolve. There is an obvious tension in the debate - on the one hand, science, research and development lead to a ever increasing number of expensive treatments to enable us to  live longer and on the other hand  the world is running out of money so that these new treatments cannot be universally available. This is happening as more societies  come to accept the wisdom  and the humanity of universally available healthcare. In the UK, recent  centralising reforms to the NHS suggest authorities feel that changes and developments should come or be imposed from the top. There is an alternative and more exciting view - and that the smartphone - that very personalised (or personalising) connected computer carried by an increasing proportion of the world's population will define the future of healthcare. The future will be defined by the grassroots - the base of the pyramid and not by the apex - and because this development is based on digital technology, it will undoubtedly happen at a pace that will surprise all.
He thinks so and he wrote a book about it.
He thinks so because he once tweeted that the future of healthcare will come out of the barrel of a smartphone and he is (and looks like) a sage.
Here are 2 movies, one from the recent Consumer Electronic Show in Las Vegas where an increasing number of personalised health related devices are being shown. The second is a promo from a startup that wants to define the future.

SHAPE OF THINGS TO COME

I read this article in the newspaper of the Society of Thoracic Surgeons, one of the 2 cardiothoracic professional organisations in the USA. It highlights the direction of the travel of the employment status of American specialists in the dominant private sector.  

DEATH OF BIN LADEN AND THE FUTURE OF HEALTHCARE

So after more than 10 years of being hunted, Bin Laden is dead. This is a MASSIVE story and nowhere else more so than the the US. It is after all in New York that Bin Laden acheived his most spectacular and deadly act. US forces led by their commander in chief Barack Obama have finally acheived what George Bush, during 2 terms, was unable to. Barack Obama today and for a while yet will walk on water. And that is why this story is huge because never has there been such an empowered Democratic left of centre President in office. A second term is inevitable and with the goodwill of the American people behind him, he truly can change American society for good.
I hope Donald Berwick will sleep easy tonight.

SMART PHONES - THE FUTURE OF HEALTHCARE

SHVD: Very-low-dose Therapy In Anticoagulation Of Patients With Mechanical Heart Valve Replacement Supported By Telemedicine
I have recently read that there are now funds to encourage start up companies in silicon valley to develop smartphone apps to use with devices that patients can use to monitor their own health.