Can physician-engineers and physician-technologists fix sick care?

The US "healthcare system" is a sick, disconnected, sick care system of systems masquerading as a healthcare system. The annual US spending is now $4.3T and over 90% of that money is spent taking care of sick patients, not keeping people healthy or deploying public health solutions at scale.

Sick care is a wicked problem. Here is a NASA overview of systems engineering.

Enter the physician-engineer and the physician-technologist. A handful of universities across the country—including Duke, Columbia, Dartmouth, Stanford and the University of Minnesota—have established dual-degree M.D. and M.S. in engineering programs in response to the growing need for a multidisciplinary approach. However, while the M.D./M.S. programs at the other universities separate their medical and engineering curricula in separate years, EnMed blends the two together in a simultaneous, integrated fashion.

Mark Cohen, dean of the Carle Illinois College of Medicine and professor of bioengineering, has been recognized as a Founder Professor in Engineering. This distinction, which will officially be awarded on February 24th, is an acknowledgment of Cohen’s outstanding contributions to the field of engineering, particularly the partnership of engineering and health care.?According to the announcement, “This professorship will allow me the opportunity to further advance my research in tissue engineering and cancer drug development that will translate into new therapies for patients in the future,” said Cohen. “It is also an important conduit to exemplify the deep connection between The Grainger College of Engineering and the Carle Illinois College of Medicine, the world’s first Engineering-Based Medical School.”?

Here is an example of a dual degree data science/bioinformatics program at Stanford and at Harvard.

The University of Alabama Birmingham School of Medicine has introduced a graduate degree program in AI/digital health/innovation and entrepreneurship.

At Northwestern, The Augusta Webster, MD, Office of Medical Education (AWOME ) has begun introducing a new?component of the medical education curriculum ?to current medical students: instruction in Digital Health and Data Science. The new curriculum component will see students meeting several core competencies and learning outcomes while learning about the health data ecosystem; the health IT regulatory environment; data science methods and research; digital health decision support; bias, ethics and health equity; and the sociotechnical context for digital health and data science.

Here is a sample digital health curriculum.

Here is what I learned teaching entrepreneurship to 1st year medical students at the University of Colorado School of Medicine.

While these edupreneurial initiatives are admirable, they are based on several assumptions that need validation in the coming years:

1. Physicians with engineering and computer science competencies are better at transforming sick care to healthcare . That's what we thought MD/MBAs would do and there is scant evidence they add sick care value.
2. The trend will not make medical school admissions inequities worse
3. The costs and incurred debt will not exceed the benefits
4. Navigating the collision of technology, the business of medicine and clinical medicine requires advanced domain expertise and will not create unintended consequences
5. Advanced programs are necessary to win the 4th industrial revolution
6. These programs are offering a product students want to buy using a viable business model to grow and sustain them
7. Graduates will finish with an entrepreneurial mindset that focuses on problem seeking, not problem solving
8. Graduates will accelerate technology transfer from the bench to the bedside to the boardroom reversing a downward innovation trend

1. Programs will do the jobs different customer segments and stakeholders want them to do , including, most importantly, their patients.
2. Alternative curriculum reform initiatives , like MBE platforms, cannot meet the needs of most medical students and graduate competent clinicians in the face of workforce shortages and challenges obviating the need for more advanced degree programs
3. We know what sick care professionals need to know about data science and artificial intelligence
4. Most medical schools have the resources, culture and ability to reform medical education

Are physician-engineers/technologist entrepreneurs the new triple threat?

Many experts say it will take that to successfully deploy technologies, like AI, which have impact and achieve the sextuple aim. The problem will be to educate and train individuals that understand each other's language and who have overlapping clinical, technology and entrepreneurial mindsets.

You should always test your business ideas. You never know how someone will use your product, including, in this case, graduates dropping out of medicine to pursue a non-clinical career, exacerbating a predicted physician shortage. Or will they be the solution to a shortage?

Amazon is viewed as the biggest threat to health systems’ core business in 2023, according to more than half of health tech experts who were recently surveyed .

At least the admissions committees won't have to worry about whether applicants can ace organic chemistry. They will have other things to worry about.

Arlen Meyers, MD, MBA is the President and CEO of the Society of Physician Entrepreneurs