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Predictions of the future love

As we totter and stumble into the next millennium certain pretenders to the throne of Aescelapius might be tempted to be retrospective on our medical brilliance so far. So be it, but here on the backwards we look to the future of our proud profession. We look to what the next century might hold for those of us toiling in the (figurative) trenches.

Although this Nostradamous-esque list is hereby humbly offered, humility (it seems from here) can too often be indistinguishable from the truth: as in "He was a humble man, Winston." "Yes but he had much to be humble about."). So here's the list:

(1) Canada will run out of doctors. Senior physicians, who have spent twenty-five years on committees to 'evenly allocate practice opportunities', i.e. keep competition to their practices at a minimum, will be unable to sell their practices necessitating postponement of retirement.

(2) Practitioners of what used to be 'alternative medicine' but now called 'complementary therapies' will abound and be paid by the state because when people aren't sick, in a medical sense, such therapists are cheaper than us because they don't feel obliged to order expensive tests or make referrals to high priced colleagues.

(3) Hospital physicians will complain that the fee schedule doesn't reflect their long hours. Office-based practitioners will complain that the fee schedule doesn't reflect their overhead. Continuing, since the time of Hippoctates, doctors will complain that (fill in your favourite pet peeve) doesn't understand.

(4) Procedures that used to be surgical will be done by radiology residents under image guidance. Radiologists will be forced to be on call. Golf club earnings will plummet.

(5) Voice mail will mortally wound telephone conversation. All interactions such as: appointments, test result discussions, consultations with colleagues, chatting, and the like, will be conducted via the internet. Voice-activated computers will eliminate the old joke about doctors' handwriting.

(6) As surgeons' and radiology residents' knowledge of local and regional anesthetic procedures improve, anesthetists will a) have even less to do, b) remain within their present state of high paranoia and, c) continue to take over the intensive care units.

(7) Doctors will enter upon business ventures that fail terribly. Just because you live in a house or eat three meals a day doesn't mean you're qualified to rush out and buy real estate or a restaurant.

(8) Medical students will 'stick with the clique' as part of their socialisation process. They will hold parties together and drink beer. They will have fewer and fewer friends who are not doctors.

(9) Pharmaceutical companies will sponsor special interest physicians to fly to exotic places. Within the profession as a whole, golf, tennis, and skiing skills will improve.

(10) Orthopedic surgeons will wear sensible shoes and one will consider buying a Jaguar. Baby boomers will espouse total hip replacement as a 'right of passage' and will deem themselves entitled to state-funded hair implants, liposuction and lasers of all kinds.

(11) Modern medicine will not find a cure for diseases caused by sloth and indolence. Stupidity, depravity, addictions and television will flourish. Deans of medicine will emanate from the ranks of internal medicine and be former chairs of medicine. None will be well liked.

(12) Despite a solid critical appraisal upon the mountain of evidence pointing to its uselessness in the practice of medicine, medical students will spend hours upon hours memorising basic science. Nephrology residents and the basic science teachers will need to know what was important one hundred years ago but nobody else will notice or even care.

(13) Administrators and senior health department officials will continue to propagate as do malignant growths. If they are lawyers or have their MBAs they will transform the system much like small cell cancer of the lung might transform a living being. Their salaries will double.

Despite pessimistic predictions to the contrary, we doctors will be well liked. Babies will continue to be born, the back wards will always be full. People will continue to get sick and get better (or not). We will be there to offer cure, comfort and solace. To treat, sometimes to cure, always to care; this is our work and always will be. We will continue to like what we do.