A new health-care system will be needed because the one we have is broken, a nationally renowned physician said in a lecture on Monday at the School of Medicine.
Haile Debas, an internationally distinguished professor of surgery and dean emeritus of the University of California, San Francisco School of Medicine, was the first annual Wintrobe Lecture speaker yesterday in the Eccles Institute of Human Genetics Auditorium.
Debas spoke on “Medicine in the 21st Century,” and gave the bad news first and the good news last.
The bad news, according to Debas, is that our health-care system is broken. It is dominated by economists, businessmen and politicians. It has failed at being universally accessible and is becoming less and less affordable.
Salaries in the profession are down and malpractice insurance for physicians keeps rising. The future may see shortages of physicians, nurses and other health-care professionals as a result, he said.
The out-of-pocket cost for insurance is rising, resulting in more people taking the risk of having little or no health insurance. The cost of drugs is also rising along with the size of the elderly population, he said.
In short, the future holds a health-care crisis unless changes are made, said Debas.
Health care in the 21st century must be universal, safe, effective, timely and equitable, he said. Some of the needed changes are for health care to be more proactive and less reactive.
Instead of finding and fixing problems, physicians should predict and prevent problems. Instead of receiving health care at sporadic intervals, there should be long-term health-care planning.
Health care should be interactive instead of physician-dominated, based on evidence instead of experience and be cost-sensitive, he said.
The good news, according to Debas, is the advancement of science and technology in the medical field. “The future can be regarded as already here,” he said.
Major trends in the future of health care may be more minimalist approaches, meaning treatment with minimal discomfort to the patient.
Advancements in imagery are allowing physicians to do more without cutting open a patient.
He predicted a fusion of disciplines to improve patient care. Instead of having clinics that are specialist-centered, like an orthopedic clinic or dermatology clinic, they will be patient-centered.
Clinics of the future will be multidisciplinary and focus on comprehensive care, he said. Debas praised the progress of the Human Genome Project in identifying what genes predispose individuals to certain diseases, many of which have been discovered at the U. He says he believes information technology, like the human genome, will improve health care.
Computers and robots in the 21st century will be able to eliminate human error in pharmacies and in the handling of medical records. They will also allow for more advanced surgical instruments.
One of the most influential forces of change for the future, he said, is the informed public. Through the Internet, the public is becoming well-educated about health-care treatments and prevention. “They’re the best ally to the medical profession,” he said. “They’ll play a significant role in the future of health care.”
The annual Dr. and Mrs. Maxwell M. Wintrobe Lecture series is funded by a gift from Susan Wintrobe Walker and her family. Debas said he remembered using one of Wintrobe’s textbooks as a medical student and said it was “beyond his wildest dreams” to be the first speaker for a lecture held in his honor.
