The emerging face of health care

Ravinder Mamtani, MD
Professor of Public Health
Javaid Sheikh, MD, MBA
Interim Dean, Weill Cornell Medical College in Qatar

Becoming a medical doctor some 30 years ago was an enjoyable experience. The practice of medicine was about making diagnosis and treating patients with medications and or and surgical treatments. Discussions on topics such as patient consent, availability of treatment options, and quality of care were uncommon.

In those days, patients were passive and accepted treatments as prescribed to them. Things were simple and straightforward. At least that’s the way it appeared.

Today, things are different. Health care delivery continues to evolve and present challenges. Mortality rates have declined. Life expectancy has increased and people are living longer, many with chronic diseases. Arthritis, chronic pain, hypertension, heart disease, stress/depression and cancer are common.

The situation in developing countries deserves a special mention. Many of them face a double-edged sword. In Countries such as India, Pakistan and Egypt the incidence of chronic diseases such as diabetes and heart disease is increasing at an alarming rate. At the same time many developing nations continue to grapple with persistent problems of infectious disease and malnutrition.

Patient priorities are also changing. Self care approaches such as balanced nutrition, physical activity and stress reducing techniques, and an interest in cosmetic procedures aimed at improving body appearances are gaining widespread acceptance.

Patients are asking many questions of their physicians. Seeking additional and second opinions concerning surgical and other treatments for serious illnesses are not uncommon. Questions dealing with prevention, nutrition supplements, stress reduction and mind body approaches such as yoga and relaxation methods are common.

Not too long ago, a physician friend of ours made a very interesting observation. He said when he first became a doctor in the 60s, the patient would say “Doctor, my back hurts. Can you prescribe me a medicine?” Now the same patient is likely to say, “Doctor, my back hurts. I need an MRI. I want to make sure I do not have disc hernitaion.” Our patients are well informed today.

We’d like to make another observation. Information available from commercial advertisements and on Internet websites is raising a lot of patient awareness concerning new treatments. This is persuading patients to demand treatments that might be usually appropriate for their condition, but also inappropriate at times. This presents a challenge for health practitioners. Clearly, patients are becoming active participants in their own health care.

In general, our society’s goal is changing from curative care to comprehensive evidence based integrative curative and preventive approach to disease and patient management.

With these rapid changes in our health care delivery, the role of the medical doctor is also changing. Doctors are no longer just medical care providers. They are also administrators, evaluators, business owners, accountants and financiers in many situations. In their practice of medicine, doctors face many challenges. One such challenge is that many are fearful of litigations and complaints against them. A US study entitled “ Fear of Litigation Study - The Impact on Medicine”, 2002 (Harris Interactive) showed fears and concerns about liability influencing medical decisions that doctors make. Examples of such decisions include excessive testing, referrals and procedures.

We should note there are newer trends on the horizon. Medical tourism, telemedicine, new government and hospital regulations are some examples of such trends. Also, global collaborative health care and education partnerships are gaining worldwide acceptance. Weill Cornell Medical College in Qatar is a case in point. Many will benefit from such partnerships.

There are also serious challenges we must confront. Examples of the these include increased health care costs and medical errors, both of which are receiving worldwide attention.

Here is a summary of our thoughts. The key factors that will continue to shape the future of health care delivery include increasing life expectancy, widespread prevalence of chronic diseases, escalating health care costs, lack of resources in poor nations and changing patient priorities. Threats such as those related to HIV and avian flu, advances in medical and information technology, government regulations , emphasis on prevention and self care, shortage of health care workers, poverty in many nations, and access of medical care will continue to present additional challenges.

Health care delivery is becoming complex. Despite challenges, it presents many exciting opportunities for health care professionals. Undoubtedly, the health care profession remains a very noble and dignified profession. And we take pride and comfort in being a very small part of it.


The medical information in this article is provided as an information resource only, and is not to be used or relied on for any diagnostic or treatment purposes. This information is not intended to be patient education, does not create any patient-physician relationship, and should not be used as a substitute for professional diagnosis and treatment. If you have or suspect that you have a medical problem or condition, please contact your physician.