https://meditropics.com/?page_id=949&preview=true
*Anil Gurtoo
*Director-Professor, Department of Medicine, LHMC
Scanning and surveying the changing horizon of internal medicine, two questions arise:
As an internist, how do I face and deal with a world of continuous and overlapping disruptions?
How do we manage our life and career in ways that keep us growing and healthy in a sustainable way?
The Coming Great Disruption: Most of the roles and functions as an internist that we take for granted today are set to be disrupted by a combination of: Technology (AI, robotic automation, big data and algorithms) and newer forms of accountability-based work cultures.
Today’s generative AI is just the beginning. So what will remain of internal medicine, as AI based systems begin to replace most of our cognitive expertise that is based on recall and analysis of patterns and their recognition. So how do we respond?
Adaptive Flexibility and Agility Equals Resilience:
- Understand technology: In order to thrive in a hyper digitized world of medicine, we must develop a firm grasp over the emerging technologies in the domains of IT, AI, Computing formats. Everyone must consider doing some online course connected with these emerging fields.
- Technology vs Care: While several technical skills are either going to be cannibalized by AI based intelligence networks or by the super specialties, what will still remain in the exclusive domain of internal medicine are:
- Integrative and interpretive skills that involve integrating vast fields of confusing and confounding data into action frames of: Holistic care
- Empathy: delivering care with empathy and compassion while integrating patient values and preferences will increasingly become a differentiator of a high performing internist.
- Collaborative leadership: internists can no longer work in silos of lone heros. We will have to devise creative ways to work and lead complex interdisciplinary teams that co-create joint management systems. And that’s going to be difficult transition given the large and brittle egos and perverse financial incentives of the present times. But this is set to change.
- Communication: The skill of having difficult conversations within diversity laden interdisciplinary teams and conflict resolution are going to be in high demand.
- Creativity and Innovation: Todays system of care and education needs a major redesign to incorporate more patient centric chronic care models grounded in the community and a move away from abstract theory into more practice based conceptual learning.
- Focus on the unique strengths intrinsic to internal medicine:
- While technical skills will continue to be important, what remains our unique value proposition has to do with the art and science of decision making and clinical judgement.
- How much breadth and how much depth? What distinguishes internal medicine from other branches is its focus on sheer breadth that spans a spectrum from: basic primary care at one end to complex multi-morbid chronic disease at the other end. While striving to maintain a mastery over the breadth of the entire spectrum of clinical care, we must also choose one sub-domain to develop focus and depth. To deal with this vast spectrum on an ongoing basis requires us to cultivate the skill of Meta Cognition: Learning how to learn by embracing change, and developing an open mind set of Adaptive Flexibility.
- Dual Challenge: Of increasing demands for clinical- academic productivity and the growing administrative-managerial demands of complex data management and public accountability.
Personalised medicine vs public health: while under pressure for meeting the public health challenges we will also have to design space time for more personalised care to particularly vulnerable patients employing innovative hybrid solutions.
CODA
Our individual lives are mere tiny dots of time when framed against the larger canvas of biological history spanning 3.8 billion years or, the civilizational history spanning 10,000 years, or the time taken by light to travel from distant stars. And yet each one of us wants a measure of fulfilment of our own personal dreams and aspirations within this tiny dot of lifetime allotted to us. But history does not move to fulfil our personal dreams and desire. Inevitably we feel frustrated. We then seek relief in: Magic, Astrology, Alcohol, God-men, and Office politics etc, there are a thousand and one ways for each of us to drown our sorrows and smother our frustration. As internist, we are uniquely gifted with a different way to seek comfort and it is by constantly saying YES to whatever challenges life throws at us by displaying adaptive agility and moving ahead, not remaining stuck in the outdated frames of the past.
As the Red Queen said
In Alice and the Wonderland:
“Today in order to stay at the same place,
We must run”
KEEP RUNNING…