Predictions For the Future of Medicine | A Q&A with Pritpal Tamber

Speakers Corner interviewed former Physician Editor of TEDMED and the Founder of the Creating Health Collaborative - Dr. Pritpal S Tamber.

What can the business world learn from healthcare or medicine?

Sadly, most of what can be learned from observing the health care industry is what to avoid. The current shape of health care supply is reliant on the elevated status of clinicians in society, especially doctors. The business of health care cut too many corners in the past so now we don’t really know what anything costs (as opposed to their price) or how to judge whether something was a success or not. As a result we have spurious understandings of “value” and the status of clinicians is being used to shield the industry from criticism. Overall, we’re seeing an erosion of trust, which will undermine the future of the industry. Honesty and authenticity are better values for the long-term.

How did the corporate speaking begin?

By being a pain in the proverbial. I have an annoying habit of wanting to understand things from a zoomed-out perspective, which is a fun conversation for some but torture for most. Doing this one too many times led people to recommend that I consider corporate speaking to help organisations see their challenges in a new light. I suspect it was just a way to stop me asking them questions.

Which event has been your favourite and why?

Being a co-host of TEDMED 2013 was both an honour and a challenge, which makes it my favourite. Behind the glamour of the TED format there needs to be substance to the topics and credibility behind the speakers. The co-host has to allude to all this without resorting to sycophancy or giving the talk away, and without taking the sheen off the previous speaker. It’s an immensely difficult role.

Tell us a little about your work in community health

Since early 2013, I have been exploring how communities define their health and how that relates to what health care thinks they should focus on. I’ve been doing this because it’s clear to me that health care’s priorities are not the same as many communities’, and we do not have mechanisms to find – and build from – the middle ground. This is, I believe, partly why many communities are getting sicker.

So, I look for community-oriented practitioners trying to operate from the middle ground. I write about their work and look for over-arching principles that others in health care might be able to follow.

What are your predictions for the future of medicine?

Medicine has become an industrial machine that it’s brilliant at finding new things and trying to treat them. The problem is that, while that’s an amazing growth model for the sector, it’s not coupled with a growth in value for people. Just because we can label something with a diagnosis doesn’t mean that we can or should treat it (or even label it).

My prediction is that the medical industry will continue to grow but there’ll be a growing backlash based on whether it’s really creating value for society.

How could changes within Europe affect the future of healthcare?

Crudely, Europe is both ageing and getting fatter. Although ageing can require more health care, it often needs more social care, something that does not scale well because it is such a labour-intensive industry. With regards to obesity, it’s the cause of many conditions that, although we can treat – such as high blood pressure, diabetes, and many cancers – we’re not very good at it because they’re at the mercy of people’s social context more than the quality of their health care. So, all in all, Europe is looking at a bottomless pit when it comes to financing health and social care with very few ideas and innovations to address it.

How do you think different healthcare models from around the world compare?

It’s pretty clear that the days of big hospitals are numbered. The kinds of conditions we’re getting now require changes in social context more than more hospitals. Some European health care models are better equipped to respond, particularly France, although they’re struggling as much as anyone else. The models in the USA and the Emirates (which are heavily based on the USA) are moribund but they persevere largely due to the economic and lobbying powers of the hospitals, rather than any cogent rationale for their existence. Middle income countries have great potential to learn from the struggles of high income countries but there is little evidence that it’s happening yet.

What is the role of tech in the future of healthcare?

Tech is always over-sold. And when it underwhelms, it’s rebranded by tech entrepreneurs and management consultancies as a way to pull the wool over our eyes. Health IT was a huge failure – and an expensive one. It got rebranded to digital health, which is seeing minimal success. We’re now being sold the potential of artificial intelligence but I suspect it’ll underwhelm as its predecessors have. Health and care are complex topics and trying to apply AI lessons from FMCG and the like is largely pointless, if not irresponsible. Tech also has the potential to further disadvantage disadvantaged communities. It’s a dangerous tool.

Why is agency important for health?

It’s increasingly clear that we cannot rely solely on the provision of ‘services’ to help people stay healthy and recover from sickness. Individuals and communities need to participate too. But we need to be careful in assuming middle class, university-educated notions of participation. That demographic tends to understand the importance of participation (which requires agency, the ability to make purposeful choices); many others do not. It’s important that any attempt to foster greater civic participation has a deep understanding of what agency is, how it might be fostered, and what barriers to its fostering might exist. Without that, we’ll only widen the inequity already growing too large in society.

Why do you love being a speaker?

What I love is helping people to see the world differently; speaking is one way to do this. Often this is actually about asking them to see the world for what it really is, rather than the artifices that we have built to make sense of the past. Pretty much all industries are the result of interpretations and assumptions made of the world at the time the industry was born. These interpretations and assumptions enable growth at the beginning but stifle it as the world changes.

What do you do to ensure your presentation has a lasting impact?

It really depends on the audience and the context, but my intention is to always help people see the framework in which they’re thinking and working. Stories of real people always help with this, as does creating a seemingly off-the-wall association. The truth is the world is more inter-connected than we believe it is – and we only believe it is because our pursuit of knowledge has created silos of thinking known as academic disciplines. The friction at the borders between disciplines is actually where all the fun happens.

What can a typical corporate audience learn from your experiences?

I don’t believe there is such a thing as a “typical corporate audience” but I do think many industries are struggling with the same problem: the radical changes in behaviour, and hence demand, we’re seeing as a result of eroding faith in big institutions and brands; more isolation as a result of economic migration and ageing; and the rise of trust in smaller, less predictable entities like personal networks. I think these forces are chipping away at many of the foundations that corporations are built on.

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