Nahum Kovalski

Surprise, it’s me, Serendipity

Technological advancement has obvious benefits but surprising downsides, too

As I’ve noted already a few times in this blog, it is very difficult to predict the effects of major advances in technology. Technology which is extremely helpful in one sphere may actually cause difficulty in another..  The most immediate negative outcome of some technologies is a drastic reduction in the need for human labor. The counter argument to this is that previous revolutions in industry have led to an overall improvement in quality of life, and a shift in the types of employment available. So for example, whereas once upon a time there was a need for a whole staff of secretaries to generate hundreds of copies of the same letter but with a unique address at the top of each one, now a single office manager can use mail merge to complete the same task in far less time. But there always seems to be a need for qualified office managers. So here is an example of a shift in employment where the new options are in fact better ones.

I just read an article speaking of the potential downside to automated driverless cars. Whether the full scale implementation of driverless cars  will take five years or 20 years, it will eventually happen.  And despite whatever hesitations people may have about giving up control of the steering wheel, driverless cars will in fact lead to far fewer accidents and thus far fewer deaths.

What could possibly be the downside to such a wonderful thing? Well, organs that are needed for transplantation often come from car accidents. As horrific as it may be, a drunk driver who is killed when he runs into a tree, can save the lives of multiple other people by donating his liver and heart and lungs and kidneys and more. With driverless cars, the car itself will be the designated driver and thus fewer organs will be available and more people will die waiting for those organs.

There are a number of scenarios for how the medical world will compensate for this loss of available organs. There is unfortunately the option to obtain organs from abroad. One hopes that such organs are accessed in a legal fashion. But there is so much money involved in providing organs for transplantation, the likelihood of criminal entities acquiring the organs is high. So, for each organ acquired, a person in (most often) the developing world may very well be killed !

Another far better option would be to 3-D print the organs we need. It might in fact be that the spread of driverless cars will lead to the reallocation of funds, both public and private, to research in the area of printing fully functioning organs. Success with this technology would be nothing less than miraculous. There would be no significant waiting time even for the most difficult to acquire organs. People would not have to wait until they are truly at death’s door before being put at the top of the waiting list for organ transplantation. And last but definitely not least, the immediate availability of printed organs would overnight eliminate the entire criminal market for obtaining organs. So between driverless cars and organ printing, there will be a dramatic drop in death rates in any population that fully embraces these technologies.

I have also noted in previous blog posts that medicine is on the verge of a major shakeup that will transform many if not all specialties. When radiologists no longer need to interpret CT’s and MRIs, they will have much more time for other endeavors. This time may be spent in research or it may be used for reeducation in another field that is similar or maybe totally different from radiology. These kinds of shifts in specialties will become commonplace over the next few decades. Medical schools and residency training will need to take into account the variability in doctors future specialization.

Interestingly, this may lead to a resurgence in interest in family medicine. As a family physician, the doctor must stay abreast of a wide range of medical topics and work as the centralizing hub for all specialty consultations. When the day comes that, for example, a cure for diabetes is discovered, endocrinologists will be heavily hit. But family physicians will still have a wide base of other health issues to deal with. And what will the endocrinologist do when a large part of his patient population no longer needs his assistance? He will adapt. He will focus more on the other endocrinological diseases or he will spend more time in the research lab or he may retrain in another still pertinent specialty. Doctors will need to become comfortable with a very dynamic work environment. Those that continue to read and to stay abreast of a wide base of medical knowledge will tend to fare better. Of course, this additional training will hopefully translate into better patient care for all.

It really is amazing how often chance events lead to tremendous advancements in science and society. The key is to keep an open mind and to always consider how an apparent negative side effect of a new technology could in fact be an opening to a whole new solution for an unrelated issue. Doctors who can see these connections and find the silver lining  in apparently negative outcomes, will do much better than their colleagues. It really will be a case of “adapt or die”.

As a long as every physician’s focus remains on improving healthcare and doing their utmost to care for the ill, doctors will be needed. Imagine an entire graduating class of new physicians who all excel in dynamic thinking and a caring personality. What a wonderful  new reality that would be.

Thanks for listening

About the Author
Dr. Nahum Kovalski received his bachelor's of science in computer science and his medical degree in Canada. He came to Israel in 1991 and married his wife of 22 years in 1992. He has 3 amazing children and has lived in Jerusalem since making Aliyah. Dr. Kovalski was with TEREM Emergency Medical Services for 21 years until June of 2014, and is now a private consultant on medicine and technology.
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