In the Future, You'll Need Your Doctor Less
What If Healthcare Just… Fades?
Most discussions of disruption in healthcare assume the healthcare system remains essential — just reshaped. Virtual visits replace office visits. AI handles documentation. Automation reduces friction. But the assumption is always that the care is still needed.
What happens when it isn’t?
Some of the most significant disruptions now emerging aren’t aimed at healthcare, but may make large parts of it unnecessary.
Prevention That Sidesteps the System
For example:
GLP-1 drugs may reduce obesity, diabetes, and hypertension across entire populations. In fact, in 2023 the US population obesity rate declined for the first time in a decade — and one leading theory attributes it to the effect of GLP drugs.
Self-driving cars could cut motor vehicle trauma by 30% or more. RAND estimated back in 2017 that even a 10% decrease in accident rate could save “hundreds of thousands of lives”. Meanwhile, even current technology promises a much greater reduction, with Waymo reporting a 57% decrease in police-reported accidents compared to human drivers.
AI therapy chatbots are already showing promise for mental health treatment, and could dramatically lower the cost of therapy — and might prevent mental health crises before they begin. And they may just be the thin edge of the wedge, presaging the automation of all medical conversations where only information is exchanged.
What happens to healthcare when obesity goes away?
Endocrine Disruptors
Each of these innovations reduces the need for healthcare, rather than streamlining its delivery or improving its process. And yet few health systems — actually, none that I am aware of — are modeling what happens when demand drops dramatically, not for elective procedures but for entire categories of care.
Food companies have run scenarios to prepare for GLP-1-driven shifts in consumption, and are already rolling out products tailored to GLP users. Where are the equivalent conversations inside healthcare?
If the number of diabetic patients drops by 20% (a conservative estimate, given the effectiveness of GLP-1 agonists like Ozempic), what happens to the business model of the average hospital? Will we need fewer endocrinologists — or none at all? What happens to primary care visits (already drastically declining) if hypertension declines by a similar percentage? What happens to orthopedics and emergency medicine if autonomous vehicles mean car crashes plummet by 50? Who owns prevention — and what happens to the institutions built on managing failure to prevent?
Failing to Plan is…
Healthcare leaders need to consider, in a world where health problems are increasingly prevented, not treated — what’s left for the system to do? I’ve spoken with hundreds of healthcare leaders in the past five years — including dozens of CEOs — and not one has mentioned the kind of “best case / worst case” modeling now common in the snack food industry.
If healthcare is going to meet this moment, it needs to do better.
And yes, there’s something ironic about hospitals taking planning cues from potato chip companies. But maybe that’s exactly what needs to happen.
Much of this post has focused on technologies that reduce the need for healthcare by preventing illness or injury. But the most widely discussed disruption today — generative AI — may reduce the need by eroding healthcare’s monopoly on information and expertise.
From diagnostic chatbots to at-home guidance systems, AI is already starting to displace parts of the care experience.
I’ve written about that in previous posts — and I’ll return to it soon.