Author: ashwinijchawla

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The potential for artificial intelligence’s integration in the medical field has been met with rising success, but also rising concerns. Clearly, there is a bit of mistrust between the public and the integration of artificial intelligence, especially when robots begin to possess human qualities, such as compassion. There is certainly a contradiction emerging between the use of technology and modern medicine. The obstacles to advancement really narrow down to the logistics of serving patients with the best type of affordable care money can buy, without compromising their comfort. What really is “best” for patients and physicians is still up for debate. From a hospital’s standpoint, the integration of machines would make things more accessible and also cost efficient. Additionally, if robots were, one day, able to replace doctors or nurses, a significant reduction in costs would be beneficial to both the hospital and its patients. This would usher in a new realm of healthcare, one in which the job market for doctors and nurses would be reduced, but also become more selective. With rapid innovations in development, the role of doctors and nurses are gradually being reduced to facilitators since the laborious features of their respective jobs are being fulfilled. However, this would also mean that despite the modern medicine innovations, the current technological advances would be deemed useless without a professionally trained individual running them. This implies that the crème of the crop top surgeons and nurses would be optimal for an effective transition to the new normal. A solution would be to emphasize that future physicians, and even nurses, need to be skilled at both: patient interaction as well as technical skills in running the new integrations of technology, whether it be microchips, organ printers, or surgical robots.

 

 

 

 

Perhaps true progression lies in hiring different doctors, rather than dispensing with them altogether, for current demands require doctors to be technically strong, but also possess the necessary emotional qualities that patients crave. This was especially iterated in a study published in the Journal of Participatory Medicine, that interviewed and surveyed people at random in four different locations throughout the Washington, D.C. area. The results were quite interesting because the responses were relatable to the everyday individual and some of the responses include the following:

“I would want their doctors to have compassion and show my loved one that they care about them as a human being, not just as another case to solve.”

“I really didn’t like this one doctor. He didn’t even look at my face. He kept walking. I felt discriminated against because maybe he didn’t talk to me because my English isn’t fluent and I’m old. He didn’t care.”

“If I could ask to improve something, I would say stop ignoring me. I feel invisible. Is it because I’m older? Doctors need to care about their patients.” (Journal of Participatory Medicine, 2015)

Clearly, there is an appreciation for expertise, but there is resentment for uncompassionate treatment. To combat this emerging problem, the Association of American Medical Colleges (AAMC), the administrators of the infamously difficult medical school entrance examination, have developed a new MCAT all together.

In this developing relation between humans and robots, doctors must stand out more than ever in their ability to connect and treat their patients through the uniqueness of human contact. With all the aforementioned research being done to increase the convenience of using robots and machines in the medical field, it is no surprise that the MCAT administrators would see a need for change. The new exam was put into use in 2015 and introduced new sections that focused on sociological and psychological aspects of becoming a doctor. The previous exam had a heavier reliance on the test taker’s ability to memorize and spit out textbook bound scientific information. The new MCAT is said to be an exam where it “asks examinees to be scientists by not only testing them on what they know, but also on how well they apply what they know.” (Association of American Medical Colleges, 2015) The main purpose behind the change was to illustrate the sociocultural and behavioral determinants that can affect a person’s health. Healthcare is a worldwide service and so it must be met with equally apt and open minded, diverse thinkers that can holistically treat a patient. With the rising demands of society–that is, physically, emotionally, psychologically, and geographically, there are several new constraints that have easily put a dent in traditional forms of treatment. It is clear that eventually, menial tasks will be completely taken over by machines.

            Thus, human interaction with patients is an integral part of residency training, which has also seen a shift in the wake of new demands doctors must face. After World War II, the medical world received a huge boost from its war achievements and advancements, so much so that physicians were held in high esteem for their extensive disease knowledge and command of science. This was a simpler time aptly captured in the memoir of Dr. Eric J. Cassell, a man who served his residency more than half a century ago. “Was my training different from residency training today? Superficially, absolutely yes. Fundamentally, certainly not… A major change is that patients have been moved to the center of medicine and the relative roles of physicians and patients have altered.” (Cassell, 1999)

Today, changes in residency must parallel the changing demands in the healthcare field. In 2016, the Accreditation Council for Graduate Medical Education

(ACGME) announced its Pursuing Excellence in Clinical Learning Environments Initiative, which aims to improve the quality and safety of medical centers in which residents train. The Council has selected eight sites in which a “Pathway Innovators Group” represents select individuals who will undertake a four-year journey as a test and model for new, experimental, and effective practices for the entire graduate medical education community. Senior Vice President Kevin Weiss, MD aptly described the current problems with residency training, “When it comes to training in patient safety and quality, residents need hands-on experience. They have the knowledge but not the application.” (Farouk, 2016) In this new development for residency training, future doctors will have emphasized learning in physician-patient interaction as well as a better sense of what the occupation truly requires.

Ultimately, the future of technology in medicine must be assessed through a patient’s level of comfort with new changes, which was most recently seen in a study where patients expressed extreme discomfort after being treated by robotic nurses. In a study conducted at the Georgia Institute of Technology, a robotic nurse, known as Cody, was used to provide primary research on the complete eradication of nurses in the performance of rudimentary tasks. The robot was to touch and wipe a patient’s forearm during the experiment. Additionally, the experiment consisted of having the robot either warn the patient that they were about to be touched, or say nothing at all. The results of the study showed a strong discord in public opinion, which stemmed from the robot’s intent of action. If the robot was just completing the task of touching and wiping the patient’s arm, most people were accepting and comfortable. However, when the robotic nurse attempted to comfort the patent by informing them before they were to be touched, most of the patients felt a strong discomfort. Charlie Kemp, the professor involved in the study, attempted to explain the reasoning behind the uneasiness that patients experienced, “In general, if people interpreted the touch of the nurse as being instrumental, as being important to the task, then people were OK with it. But if people interpreted the touch as being to provide comfort … people were not so comfortable with that.” (Georgia Institute of Technology, 2011)

This study suggests that patients themselves remain the strongest obstacles to modern medical technologies. Perhaps the fear of artificial intelligence stems from the unfamiliarity with machinery replacing human touch or even fear of the unknown potential that a medical robot may evolve to do more than just replace a nurse’s fundamental role. However, it is still very difficult to gauge true and accurate feelings to pinpoint how society really feels about technological advances.

            Even with leading innovations arising in the healthcare field, the public perceptions on the use of technology in healthcare is still largely unknown. Research on the matter is fairly new, and a recent web-based survey conducted over the course of three months tried to answer some of the underlying questions on approval ratings for new technologies. Over 53% of those surveyed had a background in healthcare and 13% were physicians. Perhaps the most surprisingly conclusion of this study was that even though 72% of the respondents agreed that robotic-assisted surgery was safer, faster, and less painful, or offered better results, 55% still preferred conventional minimally invasive surgery instead. (Boys et. Al, 2016) These results align with a discussion on artificial intelligence from Business Insider, which stated that “the reality check for the most ardent advocates of applying technology to healthcare [are] to get technology such as predictive AIs into clinical settings where they can save lives means tackling… negative connotations and fears.” (Johnson, 2016) This brings a new light to the irony of the aforementioned conversation on technology in healthcare, for those who would receive the greatest benefit from its incorporation are also the greatest obstacles to its progression.

Clearly, people seem to mistrust robotic integration in the medical world, but do they even have the knowledge to assess the differences and benefits between the old and new systems of surgeries? A study conducted by the Weill Cornell Medical Institution attempts to answer just that. The study’s objective was to “investigate knowledge and attitudes [of patients] toward surgical approaches in gynecology.” (Irani et. Al, 2016) A total of 219 female patients seeking obstetrical and gynecological care completed the survey.

Three types of surgical systems were the focus of the questions: open abdominal surgery, laparoscopic surgery, and robotic surgery.

A few sample questions of the survey include:

What is your Education level?—Please check one of the following:

• Less than high school
• Some high school/high school degree
• Some college/college degree
• Graduate/professional degree

In Robotic surgery: (please choose the best answer)

• The surgeon moves the robot’s arms to perform the surgery
• The surgeon tells the robot which surgery to perform, and the robot performs it while the surgeon supervises
• I do not know

In your opinion, which surgery costs more to the health care system/insurance? Check only one answer.

• Open abdominal surgery
• Laparoscopic surgery
• Robotic surgery

If you were having surgery, which approach would YOU prefer? Circle only one answer choice.

• Open abdominal surgery
• Laparoscopic surgery
• Robotic surgery
• Does not really matter

The differences between the three involve the way they are performed. Open abdominal surgery involves making an 8 to 10 inch incision in the abdominal area to almost completely expose the internal chest area to a team of surgeons in preparation for surgery. Laparoscopic surgery requires a minimally invasive procedure, where multiple tiny incisions are made in the abdominal area. A small fiberoptic tube, called the laparoscope, is connected to a video camera and then carefully inserted into the incisions. The video provides a less open, but still detailed look into a patient’s abdomen for this style of surgery, which is conducted solely through the incision points. Robotic abdominal surgery technically is laparoscopic surgery with an additional layer of technology added. It involves making a dime-sized incision into a patient’s abdomen, and then expanding the chest area with carbon dioxide gas. Three additional incisions are made to allow for the insertion of tubes with miniature surgical instruments attached to them. These include tiny tweezers and scissors that are literally the size of a human fingernail. These tubes with their instrument ends are attached to the arms of a robot, which allows a surgeon to then begin operating it behind the scenes.

The subjects of the survey had no such detailed knowledge of each type of surgery as aforementioned, but 89% of them had education levels of high school and beyond. However, the results were surprising in that “67.5% of the participants did not know that the surgeon moves the robot’s arms to perform the surgery, 46% of the participants did not understand the difference between laparoscopic and robotic procedures, and 37% thought that laparoscopy requires the surgeon to have a higher technical skill.” The survey exemplifies a generally decent result from a pool of varied, but mostly educated individuals. Likewise, another survey also conducted by the same team surveyed 747 adults and revealed that most respondents acknowledged the benefits of robotic-assisted laparoscopic surgeries but still preferred conventional laparoscopy. These outcomes showcase the importance for educating the public as robotic surgery and further advancements in technology become more common in the healthcare field. The benefits of new technology may soon exceed past systems of surgeries, and so it is especially important to dispel misconceptions and even fears that give rise to mistrust and incorrect knowledge on robotic surgery.

Even doctors have debated whether or not there are truly differences between surgical systems of operations. The results of a high profile study, conducted by surgical oncologists at Memorial Sloan-Kettering Caner Center in New York, show almost no difference in rates of complications between traditional open surgery and robotic surgery for bladder cancer. The researchers initially planned to conduct a longer study, however they stopped early since their findings were so well evident.

            Studies like this have helped to quantify the benefits of robotic surgery and dismiss myths of its flaws. Memorial Sloan Kettering Center recruited patients with bladder cancer and scheduled them for definitive treatment with the use of radical cystectomy from March 2010 through March 2013. Four surgeons with experience in open surgery performed all open procedures, and three surgeons with extensive experience in robot-assisted pelvic surgery performed the robotic procedures. The outcome of the experiment showed that using robotic assisted surgery versus unassisted traditional surgery hardly yielded a difference in the rate complications as well as no correlation in the lengths of patients’ hospital stays.

There can be a variety of interactions a patient can have throughout a hospital stay, some of which include the following: ambulatory service to and sometimes from the hospital, exchange of personal information, interactions with nurses, and interactions with doctors, all of which are currently being technologically altered. The first aspect has already proven to be revolutionized with the invention of autonomous vehicles. Joshua Neally, a lawyer from Springfield, Missouri, was on his way to work one morning when suddenly he felt a pain in his abdomen, accompanied with shortness of breath, all the while still driving. He knew something was off, and so he set his Tesla Model X’s autopilot function to the nearest hospital. Neally was diagnosed and treated for a pulmonary embolism. The vehicle, which he had just luckily received a few weeks prior to his near death experience, has been credited with saving the man’s life. After being interviewed by The Telegraph [UK], the man said that in hindsight he would probably not have survived if he had called and subsequently waited for an ambulance. His sharp chest pains would likely have led to Neally fainting at the wheel, before an ambulance could arrive. Even if Neally had fainted while driving, the car’s additional smart technology would have sensed when he stopped touching the steering wheel for an extended period of time. The car would then come to a stop on the side of the road. However stopping on the shoulder could have resulted in a much worse situation, if an ambulance could not reach him in time. (Robbins, 2016)

The replacement of ambulatory services by autonomous vehicles seems quite feasible in today’s world, but despite the expense, it certainly has its drawbacks. Traditional ambulance service has many flaws; in providing a service to help treat people, it runs the risk of making its drivers ill. Ambulances have several electric run machines within its walls. This requires ambulances to have a constant flow of electric energy, which implies running even when idle. This not only has seen the rise of rising fuel expenses, but also harsh emissions of nitrogen oxide, benzene and sulfur dioxide. These gases are unfortunately taken up by ambulances’ most frequented guests-that is, the workers. Studies have shown that paramedics and drivers contracted asthma, heart disease, and cancer, and the link to their ambulatory exposure and their diseases were later confirmed. As a result new ways for ambulatory services to function are being developed. But for now, the main priority involves helping to transport and treat people, rather than causing further illness for its front line crusaders.

Another portion of a hospital’s role is to serve as an honest place for patients seeking medical information. People in search of new, safer ways to replace doctors can rest assured that the solution is not so far at all; since the creation of the Internet the accessibility of medical information has significantly improved, but has not necessarily involved truthful information. The new source for medical advice has a dual nature, since it gives patients more independence in seeking out answers to their questions, but does not always give the correct answers. The Internet is by far the most cost effective modern way to find out general information without paying a visit to a doctor, especially for those who cannot afford health insurance. A recent survey conducted by the Pew Research Center stated that 59 percent of the adult population in the United States uses the Internet to look up health information. What is even more interesting was that 41 percent who sought out professional help said that the physician confirmed the diagnosis they had already made from their own online research (Castillo, 2013). One of the largest online databases for health related questions is Web MD, which now has a symptom checker. In a study conducted by Harvard Medical School, online symptom checkers prompt users to list their symptoms only to receive a computer algorithm generated answer.

The researchers made a list of symptoms based on 45 illnesses and, although extremely accessible, the online checkers are only accurate 34 percent of the time (Mach, 2015). The bottom line: “It is not nearly as important for a patient with fever, headache, stiff neck and confusion to know whether they have meningitis or encephalitis as it is for them to know that they should get to a doctor quickly,” senior study author Ateev Mehrotra, associate professor of health care policy and medicine at Harvard Medical School, said in a statement. Experts agree that this is a first generation stage of new technology that could eventually live up to its full potential, with considerable time to technologically progress and improve.

For the third world, accuracy of a diagnosis is the least of problems, for time constraints and accessibility are often the greatest obstacles to even entering a hospital. For example, in China thousands of people stand in line for days in hopes to see a physician, let alone be cured of an illness. To combat this, several healthcare apps have launched, some of which are free and widely accessible. Ping An Good Doctor app is one of the few free apps that provide free consultations from almost 1000 physicians. Additionally, the internationally dynamic service and value provider Alibaba has also created its own stake in reducing the nightmare that healthcare seekers face in China. Their app allows patients to book appointments, pay medical bills, and even interact with doctors after their appointments. The company’s main rival, Tencent, has invested $100 million dollars in a major doctor appointment website Guahao.com, which already has 37 million users (Yan 2016).

An additional layer of threat to the role of doctors as diagnostic overlords comes from a highly advanced robotic system that can correctly diagnose a patient within minutes. In Japan, the leading artificial intelligence supercomputer showcased diagnosis abilities of its own when it successfully diagnosed a 60-year-old female patient with a rare form of leukemia. This news was revolutionary, since the case had stumped doctors for months. The supercomputer, IBM’s Watson, who had previously debunked several contestants on the American television show Jeopardy, did the diagnosis within ten minutes. It even suggested a new treatment that had been proven to be more effective after sifting through over 20 million cancer research papers (Otake, 2016).

            Advances in patient monitoring have become so extensive, that even the world of nursing now has competition. A routine visit to the doctor once involved a long procedure to take a patient’s blood pressure, pulse, body temperature, etc, a process that typically depended on nurses. Today, an array of machines can monitor patient vitals, however the medical tricorder, a handheld data collector from the world of Star Trek, may soon come to life. In 2012 Qualcomm announced they would give a prize of ten million dollars to anyone who could develop the medical tricorder (Govette, 2016). In order to serve as a true functioning system, it would have to have the abilities to monitor patient vitals such as blood flow, pressure, and temperature, detect whether a person is healthy or not, and diagnose a disease. Additionally, medical engineers are in the process of developing cameras to add to existing patient vital monitoring machines. One such project came out of Oxford University’s Oxehealth; they use photoplethysmography, “the measurement of tiny changes in the color of your body, which briefly turns slightly redder each time your heart beats.” It utilizes a standard video camera as a health monitor camera that can detect a person’s heart and breathing rate from meters away in a less intrusive style than the current system of tubes and wires (Torrance, 2017). Oxehealth began as a startup, but has since received a warm welcome from media outlets, such as BBC, and also commercial markets. The Oxehealth platform is now branching out into the world of baby monitoring devices, which has also been met with great reception and successful prototypes. (RealWire, 2015) Thus it serves as a great example of a truly prosperous replacement for nurses and other current models of monitoring.

In the world of nursing, robotic assistants have also helped to reduce the numbers of nurses who get injured each year from lifting patients off their beds. RIBA, the robot for interactive body assistance, is the first robot that can lift and transfer a patient from a bed to a wheelchair. It is able to accomplish this by using its very strong, human-like arms and highly accurate sensors. (Govette, 2016).

Recent developments are stealing yet another role of nurses, that is, operation room assistance. Nurses often care for patients before and after surgical procedures. In addition, they assist doctors and oversee patient vitals and comfort during surgery. At Purdue University in Indiana, Juan Pablo Wachs, PhD, and assistant professor of industrial engineering, has initiated a powerful new prototype that can recognize hand gestures, specifically aimed for use in an operating room. An article by HealthLeadersMedia.com explains how it must first recognize a doctor’s hand gestures and translate it to the action of passing the correct surgical tool requested. This could prove to be extremely successful, efficient, and accessible, since it would involve a single robot with the ability to truly replace a nurse’s presence during any part of the surgical procedure. Ultimately, the prototype aims to help ease assisting a doctor during surgery but, ironically, the doctors are its main deterrents. Not only does each doctor differ in his or her style of hand gestures, but they also could jeopardize the functionality of the machine by engaging in a casual conversation with another human being. This allows for loopholes in the effectiveness of the prototype, especially since robots still cannot understand human concepts of sarcasm and may even hand the wrong tools over if it interprets a hand gesture incorrectly.

Following the release of the aforementioned article published by HealthLeadersMedia.com, the website wrote a follow-up article addressing the controversy that took the form of several emails and discussions. The author bluntly describes her experience from the backlash, stating “It didn’t take long for nurses to complain to me about the use of the term ‘nurse’ and the implications that robots could replace humans.” (Hendren 2011) The criticisms mainly stemmed from the usage of the word nurse in the article that seemed to offend readers who thought it undermined a nurse’s true role. One of the main critics of the earlier article, Sandy Summers, the RN, MSN, MPH, founder and executive director of The Truth About Nursing, stated:

“Robots cannot detect subtle changes in patients before they crash and intervene to save their lives, …robots cannot advocate for patients and correct the surgeon who is removing a gallbladder instead of removing a pancreatic tumor, because he forgot which patient this was. Robots cannot eject drunk surgeons from the operating room.” (Hendren 2011)

This quote highlights the role of nurses as not just assistants to doctors, but also as integral parts of the hospital experience for patients. Another one of the main critics of the original publication critiques that the role of nurses was described as a degraded version of real life and that television programs such as ER and Grey’s Anatomy portray nurses as “invisible minions who carry out low-skilled tasks such as emptying bed pans and bringing food trays.” Nurses do not just perform menial tasks that can be completed by just about anyone. Nurses are responsible for the true substance of patient care, most directly seen in how patients and their families will see a nurse significantly more often than a doctor. Although doctors are sometimes thought to be the speedy diagnosis deliverers, it is often a nurse’s touch and compassion that determines a patient’s level of comfort during a lengthy hospital stay.

The world of technology has made its most prominent mark in the realm of surgery, through the use of the da Vinci Surgical System. It is regularly used to conduct entire surgeries and is the only FDA approved system for soft tissue surgeries. Its only flaw, or rather its only restraint, is that surgeons still operate it behind the scenes. A single robot costs up to two million dollars, and the surgeon who operates it is also paid a handsome amount (Forbes Quora, 2016). The benefits of the system, as stated by the company’s website, is that it utilizes minimally invasive techniques and the robotic arms have “wristed instruments that rotate and bend far greater than the human hand.” (Intuitive Surgical Inc., 2017). The robotic arm also has a laparoscope, which consists of a light source and camera that sends the video feedback to surgeons for observation and control of the system. The key to the system’s advanced technology is its three dimensional production of images to give the head surgeon a hands-on experience just as if it were their own hands.

The new system, however, is not without its critics. In a recent interview with Healthline.com, Dr. John Santa, the medical director at Consumer Reports Health said, “[the da Vinci Surgical System] is a technology that is costing the healthcare system hundreds of millions of dollars and has been marketed as a miracle – and it’s not…it’s a fancier way of doing what we’ve always been able to do.” (Scott. 2016). There have been many successful uses of the da Vinci Surgical System, however a justification for the high costs of robotic surgery is still sought, especially since it costs ten times that of regular laparoscopic surgery.

Perhaps the most important aspect of technological integration in the medical world is its approval rating amongst those who receive it, which is not always positive. Despite its supposed superior quality of technology, the da Vinci Surgical System has received a spike in FDA conducted surveys since several freak accidents were reported. Mistakes include a robotic arm that wouldn’t let go of a tissue grasped; an accidental hit to a blood vessel; and a robotic arm even hitting a patient in the face during her own surgery. This has raised questions of the liability issues associated with the absence of human presence. For example, the family of Juan Fernandez, a man who died after da Vinci spleen surgery, received a $7.5 million dollar jury award in a 2012 lawsuit (Daily News, 2013). The irony of the matter can be especially seen in that robotic surgery aims to reduce the chance of liabilities, but can actually increase them since technological error is just as vulnerable and possible as human error. Although the artificial intelligence behind the da Vinci Surgical Systems does have the capacity to learn, it does not have the ability to take calculated risks that often distinguish top surgeons from rookies.

Beyond the simple world of surgery, the realm of a doctor’s role has also been hit by medical chips that, once implanted in the body, can deliver drugs. In today’s world why have to bother with remembering to take that one pill, when you can just have a chip pump preloaded medication into your bloodstream? According to CNN’s “Healing the Future,” there are scientists working on this innovation at the Massachusetts Institute of Technology. (The CNN 10, 2017) Theoretically, if a device like this were to be produced, it would be able to release drugs at any given time, any set interval, or any dosage amount. However, a doctor would be behind the scenes controlling it from a remote control. In 2012, an experimental device was implanted below the waistlines of eight women in a trial study to study its affects on osteoporosis. Not only did the study prove to be successful, but it has also been significantly improved over the years. Currently, scientists are working to branch this level of microchip technology into the world of birth control. In this type of dosage delivery, for the prototype to be successful, it would ideally be turned on and off by the user. Currently, the on/off trigger function is in development so that it can allow for hormonal dosages in microchips to hit the market in a prototype phase in 2017.

In addition to adding convenience, technology in medicine has been a driving force behind eradicating widespread diseases, most notably cancer. Cancer studies have typically demanded a scientist’s brain more than a doctor’s, but physical labor and treatment has always been the physician’s niche. Past and current models for treatment have always involved intense rounds of chemotherapy. However, there have been new developments in using the body’s own immune cells, nicknamed “smart bombs,” which are drugs that contain man-made antibodies. (CBS News, 2012) These can enter cancer cells and release toxins once inside. A second type of new and revolutionary cancer treatment involves using the patient’s own immune cells, in a similar fashion as if one were to fight off a cold. The exact mechanism of fighting off cancer cells is still being researched, however a trial run conducted on 14-year-old boy with leukemia proved successful. It was a last resort effort in a sense, since the boy’s body resisted treatments done with chemotherapy, radiation, and even a bone marrow transplant. This case is a prime example of how doctors’ roles have withered away to mere administrators and overseers of treatments. They aren’t actually doing anything except for an “installation” of a cure that takes matters into its own hands. Now what would happen if the faulty organs were completely replaced by an organic substitute? What would doctors have to do then, since their role today is trying to treat organ failure?

An astounding spark of technological magic has now made replacing entire organs into a reality through the realm of 3D bioprinting. It involves printing–yes, printing– custom made organs. Most recently, a printed skull replaced a 22-year-old’s diseased skull in the University Medical Center Utrecht in the Netherlands. The printer is about 6 feet tall by 6 feet wide and creates organs out of a thin film of white dust, containing human cells. It truly sounds like something out of a science fiction movie, however it has been extremely successful. It is now being used on a smaller scale than cranking out skulls, for its current target is the creation of human ears made from human cells.

The most radical and hair-raising transformation that can result from bioprinting is the replacement of the entire body’s skin, which is technically an organ. According to scientists at the Carlos III University of Madrid, “[This new skin] replicates the natural structure of the skin, with a first external layer, the epidermis with its stratum corneum, which acts as protection against the external environment, together with another thicker, deeper layer, the dermis. This last layer consists of fibroblasts that produce collagen, the protein that gives elasticity and mechanical strength to the skin.” (Cubo, 2016) There are options in the ways in which it can be created. One is to produce allogeneic skin cells that come from a stock residue of cells. The second way involves making autologous skin cells that use the patient’s own cells. An example of the second pathway is more commonly used for treating burn victims. Since it is made from human cells, the “new skin” is bioactive and can adapt to follow the previous skin’s excretions, such as semi-natural production of human collagen. This bypasses the previous medical use of animal collagen in skin transformation methods. This has become a revolutionary and fairly new way to allow for necessary, therapeutic, and cosmetic purposes. However, in all of its mystical power, it seems to be dethroning the prestige and power of doctors and crowning the world of engineering, which may in fact be the highest contender to replace doctors in the future.

Imagine going to the doctor’s office after suffering a string of symptoms, desperate to know what is wrong with you. Since you’ve already scarred yourself by looking it up on WebMD.com, you probably just want to hear a simple diagnosis, some comforting words from your regular physician, and get out of there with a prescription and a smile. However, when you actually show up to get treated, your doctor just hooks you up to the warm welcome of robotic hands that can spit out a quick diagnosis. Although this may sound like something out of a science fiction movie, this is beginning to happen all over the world. I argue that a contradiction is emerging in modern medicine regarding the use of technology. On the one hand, technology can replace much of what doctors used to do. On the other hand, patients crave human, not impersonal technological, interactions. In the past year alone, several advances in the healthcare industry have amplified the integration of technology, which threatens to undermine the doctor-patient dynamic and even the world of nursing. These developments are moving away from the human aspect of the doctor-patient relationship, and in turn they are threatening the very essence of treatment, both metaphorically, and quite literally. In response, there have been attempts to change the focus of preparation for future physicians, beginning at the entrance examination for medical school and leading up to residency training.

Welcome, to the world of medical technology and read about how it is influencing modern medicine! Scroll through the drop down menu to see portions of my final capstone project for my undergraduate career, or feel free to read it in its entirety here:

 

Sincerely,

Ashwini Chawla

Author and Creator of all literary works featured in this domain.