The benefits of uberizing healthcare cover a dark reality.
The future is here but unfortunately is not Stark Trek’s future, not yet in any case. We don’t have superintelligent machines that, with a simple scanner, can identify the smallest issue in our body or mind. Instead, we have quite a fancy AI doing some part of the diagnosis job. Not too bad, though. But the rest, all the difficult decisions, data collection, and leverage, still falls under a professional’s responsibility. Or it should. At least, I hope people have learned by now that Google can not be your personal doctor (unless you want to feed your chronic hypochondria to a psychotic level).
Uberization: the act or process of changing the market for a service by introducing a different way of buying or using it, especially using mobile technology. (Cambridge Dictionary)
The uberization of healthcare it’s been implemented in many areas, especially care at home. You have companies that provide professionals who help with personal and hygiene care, who give medication that has already been packed and prepared by a pharmacist (they are called blister packs or medication rolls), who give and administer medication that can vary every day, professionals who only take blood samples… You need a service; they have a specialised professional.
I know this because I myself have recently worked in this area of care. I would go to a house and deliver some particular care service. About ten minutes later, I would get going to the next, driving carefully but fast enough because ten minutes after crossing the door, I should be going to the following one. We, professionals, carry a smartphone that records how much time we spend with each of our patients and on the road. We get our planning with several patients that we are meant to visit that day. If we don’t get to their houses, those people won’t be looked after that day, with all the consequences that it brings. So we are constantly on that spot where we have to decide if we can or cannot give one more minute of our attention to the old lady with no children or to the middle-aged man whose social life disappeared after the traffic accident.
But I am not here to complain about why health care jobs are not so rewarding anymore. What I wanted to show with this little rating is that those people in need of help get many different professional visits with a very narrow responsibility focus and very little time. One of the biggest revolutions in nursing was brought by Florence Nightingale and her way of looking at care from a holistic point of view. We then started to comprehend that a person’s health has to be understood as a compendium of different needs, as later Virginia Henderson got to theorize. So, when as a professional, you only get to see this patient for such a small period of time and with only a subject (service) in mind, it becomes almost impossible to see that person as a holistic being. Even if you get a glimpse of it, you cannot really do anything better than say: “You should discuss that with your doctor”. A doctor who, probably, works under the same conditions and lacks the patient’s data needed to adjust the management of that patient. Because, quite often, a dependent person cannot communicate all their needs, sometimes they don’t even know they have them.
Let’s look at it from a different perspective. Nowadays, everybody is about self-care, right? When you start learning about it, you realise how important it is to balance your diet and exercise (that keeps you healthy) with lazy entertainment and a sweet treat (that keeps you happy). Of course, you have to think about your mental energy: how much time you spend socialising and alone at your quiet spot. You also start thinking about applying moisturising cream every morning because it is better than waiting for your skin to show your age before its time. And these are just basic healthcare needs that most of us have. Now imagine how much attention is required for a person with actual health problems. If we reduce the time we spend with that person and share this time between many different professionals, I don’t think we are reaching our goal.
So when we talk about the uberization of healthcare, we have to understand that if it is well done, there should always be a professional backing every step, which means time. Why do I emphasize this? Because most people think that using an app means that the professionals don’t need to spend so much time with each patient. Think about those websites where, for a fee, you can have a video call with a licensed doctor. The virtual visit is likely shorter than in a clinic, and of course, only your bust is visible (also those other parts that you decide to show, but in general, just your bust). What does this mean for you as a person in need of help?
While it makes life more convenient for those who live in remote places and delivers some care where no help can reach, it’s no substitute for a normal appointment at the clinic. The doctor won’t be able to explore your body properly; that’s obvious, so more frequently than it should, the professional will be missing some relevant symptoms. And this is crucial because we are human beings, and sometimes (a lot of times) when we go to the doctor, we don’t really know what problem we have or what we actually need in order to get it fixed.
Working in these conditions pushes professionals to prescribe wrongly, not intentionally of course, but wrongly. On top of that, we have a perfect scenario for those with a drug abuse problem. They can easily fake it for a few minutes while hiding their shaking hands under the table. Instead of getting the appropriate help, they get… well, you know what I mean.
I am not saying that virtual doctor visits are evil, but maybe, they should only be used as follows up appointments once you already know the needs of the patient you are treating.
And my last point: prevention. Most health professionals will agree: the key to well-managed health is prevention. If you want to be old and sexy, old and agile, old and happy… you have to start looking after yourself today. And more importantly, if you want to avoid expensive medical bills, the same: PREVENTION. But the issue with this is that prevention requires a lot of education, and education requires a professional’s time. The thing is, this kind of time is not as profitable as surgery time, x-ray time or chemotherapy time. Education might mean that you won’t consume drugs anymore, neither illegal nor prescribed. And that it’s even less profitable.
Anyway, it’s not like we can do anything about it. It’s not the professionals, and it’s not what the clients need. It is what the big healthcare companies are willing to provide. If we are honest, we know healthcare is not a service that, adequately provided, gives benefits (financial benefits, I mean; social and human benefits, plenty). So as long as our healthcare systems are private and financially related to some lobbies, we will not be holistic people. We will be problems that need fixing and can be charged for.
