Demystifying Medicine One Month at a Time

“The Future, Mr. Gittes. The Future!”*

The announcement of the proposed takeover of Aetna (a health insurer) by CVS (a drugstore chain calling itself a “pharmacy innovation company”) has become a big news story. What does it mean for U.S. health care? More importantly, how will it impact us as individual patients (what some like to call “customers”)?

I don’t know.

I’m not sure anyone has clarity on this yet. We’ll have to wait and see if the deal goes through, and then how the behemoth merged company brings efficiency or monopolistic pricing to the market.

Or both.

But if you want some other visions of the health care future, think about a hospital without patients as is detailed in this article from Politico.

Mercy Virtual, which opened in 2015, calls itself “the world’s first and only facility of its kind.” The 125,000 sq. foot building houses health professionals who remotely monitor and consult for dozens of hospitals and ICUs. It’s all done telephonically, er, remotely, errr, virtually.

[Another article in that same Politico issue makes the case against hospital beds, on the basis of bed rest being counterproductive for nearly every medical condition we treat. I used to get frustrated watching people ‘decondition’ while laying around in bed. It’s a serious problem, especially in the elderly.]

Which leads directly to another future question: is the age of the virtualist upon us? Yes, as predicted in a recent JAMA column by Dr. Michael Nochomovitz, who makes the case for a medical specialty devoted to care of patients through technology.

It may be the way of the future, but it sure makes performing physical exams harder.

These times. They are a changin’.

*Chinatown. Noah Cross (played by John Huston) to private investigator J.J. Gittes (Jack Nicholson). 


  1. Jane Detrich

    I didn’t think I would buy into the benefits of virtual ICU care, but after nearly 18 months working as a Hospitalist – the help provided by the eICU physicians for events like anemia and electrolyte abnormalities has been incredibly helpful. Physician to patient in person care cannot be replaced – the benefit of touch for both the doctor as part of the physical exam and the patient as part of the healing process has yet to be replicated. However, augmenting patient care with an additional physician who can take care of literally lifesaving ‘scut work’ frees up the on site physician to delve deeper into critical thinking and problem solving as well as allowing more time for the increasingly important goals of care conversations which always seem to get pushed aside for ‘pressing’ matters like hypotension or AFRVR (both of which can be dealt with initially by an eICU physician). Hopefully this will continue to grow as a symbiotic relationship!

    • glasshospital

      Great to get some real world feedback on it. And I like your point about help with the technical aspects freeing up time to have the important conversations. That seems like a really important benefit of virtual aid from afar.

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