Chapter I
Introduction
For the first time in a century, the question is no longer how to train physicians for the system we have. It is what the physician is for in the system we are building.
Recommendation
Recommendation. Encourage physicians to define themselves rather than defer to health delivery systems, payers, regulators, and companies. Fund physicianship as a legitimate object of scholarship itself, projected forward rather than described backward. Adopt one durable rule for what may be handed off: work that can be fully specified, independently verified, and audited afterward may go to a machine, a colleague, or the patient, whereas judgment under irreducible uncertainty and virtuous engagement may not. Convert credentialing from a fixed qualification into a portfolio of current, diversified, independently verified competencies, because fluid and plural identity without that oversight schema is unverifiable practice.
Sections
- 01Futurism in Biomedicine: The Mosaic MetaphorChange of this kind does not arrive as a revolution, with the world one way in one moment and another way the next. Nor does it arrive as an evolution, through intermediate states that emerge in stages and leave ample time to react.
- 02Arc of Medicine: Historical ThreadsThe first traces the ebb and flow of medical schools. The second follows the regulatory sphere of organized medicine, its boards, its societies, and its licensing structures. The third recounts the history of teaching hospitals and residencies.
- 03Physicians Evolving: Hippocrates 1.0 – 4.0Medicine has reorganized itself perhaps three times in its recorded history, and we are now inside a fourth.Exhibit 1.1
- 04The Hippocrates 4.0 Physician: Plural and Fluid IdentitiesThe overarching view of the future physician advanced here is one of diversified identities and roles.1 definition
- 05The Attitude of This ReportFirst, this report approaches the question of the future physician from an entirely different plane. It does not ask which tasks will survive automation, nor how to defend existing scope.Moonshots