Dramatic changes in healthcare have been initiated by advances in IT, digital technology and online media. More and more people have access to medical knowledge via the Internet. Online communities empower patients and contribute to a more equal relationship between doctor and patient. It requires a different kind of doctor-patient relationship than before. That is why we must now invest in training the doctors of the future.
From reactive to preventive health care
In the 21st century, the old hierarchical patterns of the doctor-patient relationship are a thing of the past. The next generation of doctors must be trained differently to be prepared for the patient who is on equal footing. The easy access to medical knowledge and the development of digital health technologies are changing the balance of the doctor-patient relationship. The technology enables patients to measure vital signs at home without having to visit a doctor. We face an aging population, rising healthcare costs and a shortage of healthcare workers. And the paradigm shifts from curing disease to preventing through healthy lifestyle. All this means a lot to the work of our future doctors. Different requirements are made for knowledge and skills and the relationship with the patient also changes.
Medical students must have a realistic picture of the challenges that await them before they start their studies. In 2040, doctors are expected to fulfill different roles: in addition to being a general practitioner/medical expert, they will also be a coach and a trusted empathetic translator of online medical knowledge to the patient. In addition, the doctor of the future is a partner in the network with other health professionals and, finally, an innovator who aims to improve the quality of the profession. These roles are interchangeable and depend on the context in which someone works. A lifetime of medical care does not mean you always do the same thing.
Careers can meander, so I started my career as a medical assistant in Dutch hospitals in connection with the training as a tropical doctor in both surgery and gynaecology. Then I went to Africa to put what I had learned into practice as a district doctor. After returning home, I took an MBA at the Rotterdam School of Management and then worked in various management positions, including at health insurance companies and GGDs, as well as implementing change processes in hospitals and municipalities. Continued development is important to me. You must keep in touch with practice. That is why I also followed the specialization Art and Society in my working life and later got my registration as a company doctor. And I still work, alongside my administrative work in KNMG, as a company doctor. In every step of my career, I take the experience of the previous workplace with me. I experience this broad view as an enormous added value, for myself but also for my working environment. To me, lifelong learning is not just about learning new skills. My focus is primarily to have tools as a professional to remain relevant and flexible in a changing social and working environment.
If we see that our profession is changing and our desire is that we allow people to be flexible in their careers, then we must train generalists. Who are able to think and work beyond the boundaries of their subject. The doctor of the future must be able to work together in a changing working environment, which places high demands on adaptability and flexibility.
Doctors outside the hospital
In light of the challenges facing healthcare in the next 20 years, professional differentiation outside the hospital will become increasingly important to meet society’s healthcare demands. Almost half of all medical students already end up in an extramural profession. While, according to research, they seem to be more interested in clinical continuing education1. Internships are often carried out at the hospital. It can give the false impression that there are few other options as a doctor apart from the well-known hospital specialties and general practice. Only 32.1% of all medical students come into contact with social medical professions such as insurance doctor, company doctor or doctor via their studies Society and Health1. Medical students are less likely to consider choosing a social health profession if insufficient information is provided about it2. And it’s a shame, because there are many interesting opportunities outside the hospital walls. Disease prevention and prevention is becoming increasingly important and there is a shortage of general practitioners, geriatric specialists and paediatricians, but unknown means unloved. Therefore, the students should have the opportunity to come into contact with medical professions outside the hospital at an early stage in their education.
Medical education must develop because our future doctors will meet their patients in a completely different health context than today. We increasingly focus on prevention and the prevention of unnecessary care, whereby the patient is approached as an equal partner. And the constantly innovative knowledge and technology requires lifelong learning. Our future doctors must start with a broader orientation to the profession already during their education and be open to acquiring new skills. So that our society can also count on the best possible care in the future.
René Héman, chairman of the KNMG medical association
1 Unknown makes unloved; Does greater awareness of certain specialties address shortages? – Medical student
2 Research report-underexposed-follow-up programs-complete-revision-1-2.pdf (deMedicinestudent.nl)
More columns by René Héman