I’m in the midst of reading Andy Kessler’s new book, “The End of Medicine.” It’s an important read for those building or investing in healthcare services companies.
Kessler plays the layman in the industry peering at it behind the lens of a tech/finance junkie. He sets out with the basic understanding that the healthcare system is enormous and bloated with cost, and brings hope that there’s a killing to be made in overhauling it with technological intervention.
That’s an old tune, and Kessler’s no geriatric fiddler. His ”special sauce” lies in uncovering the diagnostic inventions that will remake the industry. Sure, electronic medical records will help, but Kessler digs and digs for stuff that will not just offer productivity to the existing infrastructure, but rearchitect the infrastructure with bits and bytes. Machines that read mammograms for a fraction of the cost of radiologists. That get cheaper and cheaper every year. That scale.
Kessler writes:
I’ve seen it with PCs, cell phones, TiVo, routers, DVD players, electronic engine controller in autos, and video games. 3-D graphics live on this learning curve, providing more and more photorealistic animations. And just like that, because of new technology entire careers disappear like trolley car conductors of old - phone operators, tellers, stock traders, librarians, postal sorters, numbers runners for bookies, draftsmen, magazine layout experts, film editors, stock traders and on and on. Were doctors next? I secretly hoped so.
Reading the above, I couldn’t help but think back to a session at the Always On Innovation Summit this summer at Stanford. It was called “What’s Your Long Bet?” (link to video archive), and it was participatory. The audience placed long bets, ones that could be quantified and were specific. Mine was: “By 2030, doctors per capita (domestically) will at least halve.” Considering that this ratio rose by nearly 50% between 1980 and 2001, that’s a pretty bold claim. I think, though, that ever more sophisticated and cost-effective diagnostic tools and information services will offer substitutes.
I’m not finished with “The End of Medicine,” but I think Kessler might agree.






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