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I had an interesting eye examine recently. They placed me in a darkened room with a machine on my head. The video screen in front of me lit up, and there was my doctor via video chat. She asked me questions while the machine buzzed and whirred at her direction, taking various measurements of my head, looking in my eyes, etc.

At the end she pronounced my eyes healthy, and prescribed me new glasses.

She was sitting in Florida, 2,000 miles away....she told me she saw a new patient every 20 minutes, all over the country, and could do 20-30 patients every day, never leaving her desk. The examine cost next to nothing. The glasses are automatically machined in the back room, and were ready 1 hour after I selected the frames.

That is the future for all medicine I suspect - remote doctors serially seeing dozens of patients all over the country each day using tele presence and medical robots, with solutions crafted and ready to go while you wait. In the case of the doctors, your prescription, new brace, whatever, is at the front counter waiting for you as you check out. Ideally patients would be sorted going in - joint problems? You are hooked to a specialist that sees nothing but that problem all day. the flu? There is a specialist doctor for that, covering every case of flu in the state.

The GP will be a thing of the past.

Kartik Gada


Optometric exams might be possible just from a smartphone app tied to the camera before long. Ultra hi-res imaging with built-in magnification matching the database of millions of previous eye exams will be unbeatable. That will be a different ATOM AotM.

Regarding your Florida Optometrist, that is good! But I wonder why international providers haven't completely captured the US market. The cost from India, or even Poland, would be an order of magnitude lower than the US. Basic optometry isn't the same bar of skill as neurosurgery, so US providers should either be completely outcompeted, or one Optometrist like your one in Florida eliminates 20 others just from sheer volume.

With robotic surgery, there is still no network effect and certainly no AI/Cloud layer. The innovation so far is only in precision and small incisions, but much more can be added to that when you have data and all machines connected to the cloud.


You all are way out of your league with this. Things like Lasik or optometry exams, while really cool and technical, with great emphasis on physics (optics and lens creation) are WORLDS away from the kind of health care anyone expects, or suffers from. They are great innovations in 1 dimensional fields. The human body with its physiology and interaction with the environment for years, including symptoms such as "pain" make futurism in this case funny. All Da Vinci did was help a physician gain a new skill for improved RECOVERY (less invasive procedure). It didn't do anything for replacing the human or cost. Actually, it increased expert skill requirements and thus, cost from both a human and robot point of view. In a world where everyone wants more and has less, this could easily be just as irrelevant as it is relevant.

Yes, I am a physician.

Kartik Gada


All Da Vinci did was help a physician gain a new skill for improved RECOVERY (less invasive procedure).

That is huge. Time spent in the hospital and the productivity loss post-surgery has been slashed.

It didn't do anything for replacing the human or cost.

No one said it did. Plus, the article is about the future of robotic surgery. Da Vinci is outdated because it has been protected by patents. It was innovating in 2001, but not now.

Ed Zimmer

I'm afraid Palamas may be clinging to the past (an all too common condition). I believe medical care will be undergoing major changes over the next few years - and not just from robotics and enhanced communications. After having benefited from Medicare the past 20 years, I'm a firm believer in Medicare-for-All (and believe its coming soon despite the monied resistance). From discussions I've had through The Economist during the past few years with physicians, I've learned there are two distinct camps - those that absolutely abhor the program and those who have learned to live with it (and actually enjoy the practice, albeit wishing it to be a bit more generous in its fees).

The difference appears to be between those believing that medical care should be about establishing personal relationships with patients, with regular hour-long appointments scheduled two or more times a year (which approach is obviously not economically practical given Medicare's mandated payment rates) - and those who accept those rates and have made medical care a "business", organized for efficiency and making maximum use of lower-skilled employees (nurse practitioners, physician assistants, etc.) and labor-saving equipment. I believe the "business" approach will be the winner. My experience with the "business" physicians has been infinitely more satisfying and assuring than (what I consider as) the old-style practice.



I live in the present and more importantly, IN this system you are talking about. I am in diagnostics. "It will be undergoing"??? It already has my friend. You think there's enough money or time for all of the patients, let alone the boomers, who will crush the system in the US starting in 2025? Regulations on physicians have only gotten greater, education costs only gotten MUCH steeper (with higher interest rates even!) and mid levels are laughable for anyone who actually needs a physician. This is not a knock on them, rather the expert training it takes that the public wants increasingly for free. Also what the hospitals want to make as commodity or worker bee.

The business approach is already the winner.

I recommend you eat right, exercise, and forget physicians all together. What's coming is going to be funny for those who lack discipline and fitness, which is most of America, at this point.



There is no bright future for robotic surgery. There was a bright surgery for 70 year old retiree age types with prostate cancer ... way back when I was in medical school. Some can still pop wood. The others, well, who gives a shit anyway. They are fat and 70.

Not trying to be crude, but rather funny, because this is the truth.

The emerging market problems with an increasingly strong dollar is the real issue coming upon us in the world ... or the fact that socialism is totally failing and what are the antifa types going to set off in all of these countries ...

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