Fact-checking Stanford’s 2020 Health Trends Report
Last week Stanford released its annual Health Trends Report, with the title “Rise of the Data-Driven Physician.” The forward describes “a health care sector that is undergoing seismic shifts, fueled by a maturing digital health market, new health laws that accelerate data sharing, and regulatory traction for artificial intelligence in medicine.”
To gauge physician reaction to this technological healthquake, Stanford conducted “a comprehensive survey of 523 U.S. physicians and 210 medical students and residents”. Their conclusion (my emphasis):
What we found boils down to one central idea: physicians expect new technology to transform patient care in the near term, and they are actively preparing to integrate health data—and the technologies that harness it—into the clinical setting. In other words, we are witnessing the Rise of the Data-Driven Physician.
Well, there’s no question that technology for health and medicine is changing, and quickly. But are doctors really embracing this change?
Let’s look at the “one [sic] central idea” of the report:
“physicians expect new technology to transform patient care in the near term”
Physicians “are actively preparing to integrate health data—and the technologies that harness it—into the clinical setting”
and see if Stanford’s survey data support it.
1 - “Physicians expect new technology to transform patient care in the near term”
In a section entitled “The Future Physicians Toolkit”, Stanford asks this question:
Which of the following innovations do you [expect to use - Students and Residents / personally use - Physicians] in your practice?
As we can see by the graph below, a large majority of practicing physicians are using EHRs, and after billions of dollars in federal subsidies this is no surprise. Probably also not surprising that large majorities of those practicing doctors are not (yet) using AI, virtual reality, wearables, personalized medicine, or even telemedicine — much less robotic surgery.
A lot more surprising: large majorities of residents and medical students do not expect to be using those technologies, either. Rather than expecting “new technology to transform patient care in the near term,” the majority of surveyed trainees do not expect to use these new technologies at all!
86% of surveyed students and residents do not expect to use artificial intelligence in their practice.
Almost 75% do not expect to use genetic screening or personalized medicine.
59% do not even expect to use the relatively prosaic “telemedicine”.
2 - Physicians “are actively preparing to integrate health data—and the technologies that harness it—into the clinical setting”
To test this proposition, Stanford’s survey asked this question:
“Are you currently seeking out additional training or classes to better prepare your self for innovations in health care?”
According to the survey, 47% of physicians (and it’s unclear whether this includes residents) answered yes. The number for med students is 73%.
So we can at least say that a majority of medical students are interested in preparing for innovation, while only roughly half of “physicians” are.
Among those who said they were planning to take additional classes, the most popular topics were statistics, population health management, and genetic counseling (and in the graph below I’ve combined the data for students and physicians):
I don’t think the data mean what Stanford thinks they mean
So what are we to conclude from Stanford’s own data? Can we say that physicians are embracing technological change and “actively preparing” for it? Not really: by their own data, large majorities of physicians surveyed don’t use or expect to use any of the innovations mentioned — except for EHRs. And most practicing physicians aren’t planning to take any classes to prepare for innovation, either.
The one bright spot is that almost three-quarters of medical students said they did plan to take courses to prepare for new trends (compared with roughly half of their more senior colleagues).
But given that sizable majorities of students and residents do not expect to use AI, genetic screening, virtual reality, or a host of other potential innovations, we have to wonder: which new trends do they think they are preparing for?
Another worrisome sign comes when asking students, residents, and attendings to value a variety of innovative data sources:
Although the graph title suggests it’s “the next generation” that will find these new sources of data valuable . . . the data shows that students and residents were less, not more, likely to value these innovative sources! And large majorities in every group failed to rate any of these sources as “very valuable”.
Stanford seems to think that their survey shows a growing interest in tech innovation in healthcare, especially “the next generation of physicians”. Their data tells a different story:
neither practicing physicians, residents, nor students use or expect to use some of the most potentially-transformative technologies of our time, including AI, VR, and telemedicine.
while a large majority of medical students are interested in taking courses to prepare for tech innovation, particularly in data science, they are actually less likely than older doctors to value innovative data sources.
My suspicion is that these doctors-in-training continue to think of “health data” and “health innovation” as synonymous with the only IT innovation they believe that they will use in practice: the EHR. They recognize that they’ll need data science skills to use all that EHR data, but they clearly do not expect to use non-EHR innovations, or the data from them.
Does that show a worrisome ignorance of the tech forces that will change healthcare? Or a healthy skepticism of the hype around AI and other innovations? Time will tell.
Stanford Medicine 2020 Health Trends Report
Large majorities of medical students and residents do not expect to use AI, VR, telemedicine, or a host of other innovations in their practices.
Stanford seems to think that their survey shows a growing interest in tech innovation in healthcare, especially “the next generation of physicians”. Their data tells a different story.