Future of surgery
For the time being the surgeon will be irreplaceable in the operation room, despite all the technical developments. Robots will enable us to operate more accurately. With 3D computer data there will be more navigation tools while we operating. For example a pair of glasses, which can project 3D fluorescence imaging with combined PET imaging during the operation .
Positively our core-business will there
In the Netherlands, there will be a couple of macro-economic developments that will hugely influence our work outside the operation room. I will discuss a couple of them .
This is an illustration of the Dutch situation and how the government and the health insurers see the future for the medical expenses. The inverted pyramid shows the current situation , the biggest cash flow goes to the 'second' line ( hospital care) , less to the first line ( general practitioners ), least to de 'null' line (people) . The future will be the complete opposite .
The government and the health insurers actively manage this.
They make agreements with the hospitals to do less and decrease the expenses.
The hospitals are forced to dispose of certain tasks, which can take place in the 'first' line. For example the small surgical excisions under local anesthesia.
The surface in square meters will be less in the renovation plans of hospitals or in newly build hospitals.
The government and health insurers spend a lot of money on the development of self management ( eHealth & prevention) in the 'null' line.
Machteld Hubert plays an important role with her redefined new definition of (positive) health;
'a state of complete physical, mental and social well-being and not merely the absence of disease or infirmity'.
She developed a instrument to score this health ( see illustration) and she has established a institute of positive health: www.ipositivehealth.com
Outside the operation room the digital revolution will evolve rapidly. Electronic devises will be able to collect patients data, electronic patients files will be in possession of the patients, video consulting, networks and social media will dictate the future of surgery.
I believe that the surgeon in the future will be working partly outside and partly inside the hospital.
Outside the hospital
1. Outpatients consulting/ second opinions ( facetime/ video )
2. Patients networks
3. small surgical operations under local anesthesia in the 'first' line
Inside the hospital
1. The 'real' operations and the expensive diagnostics
In my opinion the developments are going so fast, that an active attitude and anticipation of the surgeons are necessary. To make our work great again.