The Future of Medicine: From Physical to Online to Mobile to Wearable to Implantable

Just as the silicon “ink” dried on Telemedicine: The Future of Medicine, someone, somewhere, pronounced that there is a future for medicine beyond the future. This was no sweat for me, since I’m into the future of the future, especially when it comes to medicine and healthcare.

My first set of books on health care law and policy were about complementary and integrative medicine, and used both these concepts of “beyond” and “future:”

That’s the sequence: A, Beyond A, and Future A (substitute A for medicine).

In the piece on telemedicine, I noted that we can define telemedicine many different ways: there are legal and regulatory definitions, operational definitions, professional definitions, and so on – it depends on whose vantage, matters. If you are a physician in home state X and diagnosing a patient in state Y, where you are not licensed, via an online technology, then the statutory definition in both states X and Y very much matters. From an overarching perspective, though, the Olympian view, telemedicine refers to a healthcare or medical service provided without the physical presence of a physician.

What’s physical presence, anyway?

In medicine, we look to the art of diagnosis, an art and not a science. It entails careful observation. And when comparing complementary, alternative and integrative medicine to biomedical models, we have, for example, the subtle pulse diagnosis of, say, traditional oriental medicine or of the Ayurvedic physician.

The physical presence is still important. In medicine, as in love.

We are also moving as a society into the expanded boundaries of relationship and self-definition offered by new technologies.

When I spoke in Riyadh, a few months back, on legal and regulatory issues affecting the health and wellness industries globally, I talked about the growing market for therapies such as: anti-aging medicine, lifestyle treatments, cosmetic surgery, aesthetic medicine; and about related markets for everything from mobile health to medical spas to online medical clinics to mobile medical apps and medical devices–and how laws are evolving (or should evolve) to meet the expanding business boom.

To graph the different branches of regulation, I divided the legal system into regulation of practitioners and practices on one hand, and products on the other. This more or less corresponds to the way clients stream into my own law practice – i.e., as practitioners or facilities (doctors to laboratories, psychologists to clinics, for example), or as products (this is more on the FDA side – dietary supplements, cosmetics, medical devices).

I see the future of health care as morphing from the physical world, to online interactions (telemedicine in its narrowest sense), to mobile medicine, to wearable health technology, to implantable medicine.

As one physician commented: “As you noted in your speech, telemedicine is the future of the medicine. We are going there with or without our approval. ”

Futurist Ray Kurzweil wrote about the growing interface of human and artificial intelligence; the downloading of our brains into computerized gizmos, and expansion of our conscious intelligence throughout the universe in these indestructible new bodies. That vision still lives, whether you consider it utopian or dystopian. Healthcare is one of the bridges that will carry us into this new version of humanity. In fact, my guidance says that this is the last lifetime in which we have physical bodies.

Once again, telemedicine defined, in its broadest sense, as medical service largely provided without the physical presence of a physician, is, in my view, the future of medicine. However, the concept obviously expands to mobile, wearable, and in the not-too-distant-future, implantable. Physician licensing laws and much of the regulatory framework emerged in the late-19th century. From a legal and business perspective, the question is how to create viable business models as regulatory models are struggling to adapt to 2.0, 3.0., and so on. From the perspective of human destiny, the questions are much larger.

That’s why in Future Medicine, I look to energy medicine as a likely evolution of the legal system and the health care system at the crossroads of developments in the way human beings care for body, mind, emotions, environment, and soul. Because once we move from physical to online to wearable to implantable, we will understandable everything around us in a much different way – and we’ll be at the threshold of a new humanity, connected more deeply and ideally in a way that enhances personal wholeness and at-oneness with the wholeness of the whole order.

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Michael H Cohen Healthcare & FDA Lawyers

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