Press "Enter" to skip to content

O Futuro da Prática Médica | David Schlesinger | TEDxUNIFESP


hello I am neurologist formed
I entered college
efe ago doctorate in genetics
five years ago I dropped one
office 11 a career
researcher who is a career
academic in genetic mount for
genetics laboratory with
much smarter people than
I call links
it is in those five years I had a
amazing opportunity to see a future
that as the pt had already written is
that the future is already here it just does not
okay and comment is distributed and I see
that future day by day because we
creates this kind of thing people are
I am exposed exposed every day there
an intelligence technology
genomics computer artificial
is that it is amazing and this poses a
just my vision of what will be the
future of what will be the medical practice
he talked a little of what I think
what will happen in the next 20 years
in contrast to what happened in
80 years medicine has evolved
dramatically over the last 80 years
my grandmother went to college
medicine a doctor has 93 years old
entered college in 1944 is the
medicine that she ‘s seen throughout these 70
years in this case is changed radically and
it changed for some reason is very
specific medicine that permeated
that several of the speakers spoke
about this
the first thing is are drugs
or the treatment as a whole as
we gained knowledge about the
biological bases of diseases in
last 70 and 80 years in
will allow treating patients with a
effectiveness with a very efficient
larger then we understand us
You can understand what is what
patients have and everyone
can treat these patients in a
much better way very long time and
still walk but we improved world
think it was in 1944 when the
Penicillin was coming right in Brazil
then a medicine that was made before
penicillin and penicillin after only
very different medicines
just think of the not here at school in
medical school there on the other side
the city is that it was where I did
college is to have a syphilis chair
He had an expert to you glad
no longer has reason to exist after
that existed penicillin
we still learn about it simple
there still is but you do not need a
specialist a professor of
Syphilis is the same way as
for some years be discussed by
example , a professor about
HIV and AIDS
the other thing that really changed medicine
in the last 80 years were the exams
image is the imaging from
90s and resonance tomography
They allowed that we enxergasse
some things in patients in
disease processes before we
I could not see it
revolutionized some areas of medicine
more than others
this is the neurologist I still learned
a very detailed neurological examination
but it was much different than
someone who did his residency in 1970
learned is because we had
much more information and we had
almost the gold standard you make a
physical examination but do you have any
important information more
know what is the disease process that
It is going on a patient
the other thing that happened is that it is
hard to write himself or I
supposedly home yet in milan I
‘m right on the edge is of older
the millennia but what happened that
transition Here the internet has changed the
Access to information is when I
I entered college just before the
we had here in the full library
Car magazine is free to wait the
magazines get here is the library
for us to have the information
today you have access to a PDF
or the life of a congress
while it is happening then
access to information access to
researchers this as easier and
it has been democratized costs nothing
it costs Internet access to
then medicine has changed a lot but if you
look medical practice day to day
doctor of course he has more
tools we have more tools
to treat diagnose patients
but the practice on a daily basis it is a
photo that chapels in 1938 by I
‘m talking about 80 years is measuring
blood pressure of the patient is measured
the temperature of the patient when he has a
suspected infection doing an exam
of blood
these things have changed very little right
This process in which a doctor sits
with the patient conversation with the patient
it has changed very little is right has more
information have more knowledge has
more tools but the day to day
doctor changed little and that’s what we
next 20 years will change dramatically
so for medical students for
those making medicine today this is very
important because when you
are at the peak of career
the girl will will let you
behind
if you look the history of
80 years and tried to draw a
straight line is what will happen
because we are really accelerating
knowledge and technology and some
things in particular that I will speak
hereinafter
already in the 50 ‘s we spoke of star
trek and star wars
I enjoyed being weak is r 2
but the stocks we had a
global vision is a vision is
11 that the technology could lead to
We’ll run it it was a
little device that the doctor focuses carrying
and made the diagnosis in real time is
acquire all the information they
They had no medical knowledge but
acquires the information already gives
diagnosis and is already medicate’ll give
treatment and and this is a dream but this
It is becoming a reality it will
become reality in the coming years is
It is
What has changed this practice which is
generating what are the causative factors
this fundamental change in practice
medical in the next 20 years
things that happened in the last 10
20 years
okay first two factors is us
think one is the cell
access at any time
information is more than that is not
only access to information but today
We have in our hand everyone has
not only access to the internet or by mere
at that time but we have a
camera we have
various sensors
we have are applications that allow
we do the math we
before I had to keep in our head
we have a tool
constant communication that was not
existed even ten years has ten years
behind
Furthermore you do not need
all the computing power in our hand
is the Amazon in 2002 when he realized that
they used more servers
of them in the three weeks before Christmas
because it was there he had the bulk of it
computing demand right of
their servers
they had their age in the rest of
year so they decided to use this
idleness and sell this time
server and it started in
processing cloud is the cloud that
today we talk about whatever does not come to
Cloud access is almost infinite
computing so today you can
have access to a computer in the mobile
and you have access to a computer
that is the infinite distance
just you need you
You have to do with it you can
the other thing that will change is that is
You’ll have to share
we had 200 million
computers in the world today at 2 billion
cell phones and smartphones
when you have something that happens in this
order of magnitude the cost of handsets
the course
component falls a lot and with the fall
the cost of components other things
We were coming around that we in
mercedes on a daily basis but the same
processor that serves a smartphone
It serves a drone is for a car
right driving alone then all
these things will come around this
says a source ecosystem that emerged
these last ten years
It was then whatever we say clear
a patient can measure blood sugar is to
divide it is his blood glucose at home one
Type 1 diabetic patient can measure
several times a day today to
We have to continuous meters that
stand is placed in the subcutaneous
patient
but what about when we can measure all
other things we measure in
central laboratories as the mother of
linx is the distance it is not
happens from night to day but he
is going too fast and this
will allow us that one
long cycle we needed to ask
examination for the patient he was going for
laboratory returned this will will pass
very fast
an example of these I have no
participation in this company is okay but
has this this portable ultrasound
ultrasound before cost 80,100,000
dollars is nowadays this is a gift
that is costs 6000 US dollars or more
less right then a doctor could
load this ultrasound in your pocket
instead of listening to a patient
try using only the sounds whether
the patient has a condensation
lung or cardiomyopathy it will
see this information and it will
be able to communicate this information with
much given to a server is
plant that will process
information return part of these
information processed it will be
tool when we’ll have the
tool at the time that we are
seeing the patient and not in a long cycle
of leaves makes an appointment redials
examining this thing back a month
back we will make real – time
genetic sequencing
this is a picture of the way it has
today we have three sequencers
large production capacity
I did not bring it here did not come here
to speak of his mother specifically
I only brought one example is is a
sequencer that we have we
He bought four years ago
today it is a sequencer calls in
powder
he is half of what the sequencer that
bought four years ago was already
will continue this miniaturization not
only in genomics you will continue
in all areas and image in genetics
laboratory tests in
interpretation is the treatment
Robotics will change have second thing
What happened the second group of factors
that will change
one of them is the game is because
video game and why I really like
this vision that we never know the
where it will come and innovation is
innovation came largely from
passionate about the game and wanted
ability to process are video
and increasing the capacity of
video processing that has been
is increasing over the years a
giant leap also in the last
decade with the video processors
video cards
these ports do calculations too
quickly a very large capacity
it was realized more recently and here
the other image is an image on a
artificial intelligence algorithm is
this is a type of diploma or is is is
that intelligence algorithms
those artificial those algorithms
that existed since the 60’s and 70
and that did not work right
Now with the processing capacity
through gp each video cards
and by the amount of data that the
we have available right now
joining these two things founding
videogame gathering the data we
It is collecting artificial intelligence
It works and we will see a breakthrough to
we are seeing every new day
advances in artificial intelligence
It seems unbelievable this is two
quick examples
one and
then speaks the interpretation of speech
this is a google graph showing
as in recent years models
the artificial intelligence
classifiers intelligence
Artificial who play already speaks
They arrived at the level of interpretation
human
the one thing we will never understand
a patient in fact we will
we’re already getting to the point where
classifiers do intelligence
artificial does another equal work
to understand speech as a human
we can now images
interpret video images
static
we can in the same way that
We’re playing then and
Now we are already at the human level
It is already better than the human level
this will continue to improve in
coming years
we already have algorithms
artificial intelligence that can
then make the first defense is
first comment is long term
is that the image recognition not
It is a viable career model
long-term
then yes radiology pathology
It will be very difficult to have a market
to the number of radiologists and
conditions that exist
much less to for the new graduates
in the next 20 years
we speak but was unsuccessful you
will never reach the point where it will
replace the machine will not
replace the human right people hear
so much in different areas
we rarely was on the
doctor is an example in which the blood count
the 40 and 50 was done with a
computer you took looked in
Microscope a person looking in
expert microscope and counted there
the number of cells that had the
cubic millimeter and with that you
was delivering a CBC that there
It has a clear human error but much more
it is very expensive you train a
doctor to be counting cells
in an xyz format it is and the and had
much resistance when devices
Automatic count entered the
market but nowadays is us
It prefers the high apparatus
I think it is much cheaper and is
It allows us to do blood counts
is a lot more people to stay
available which is part of my
personal mission of personal mission
connected to the mother of the mission of which is
make accessible diagnosis
Then automation robotics
It allows us to become available
and no one today does not say this program
It was automated in I do not accept this
CBC I want one that a doctor
Look at the sessions of the recessions
You want ever an expert
look but overall not
so what makes a doctor in their
practice it gets a story
clinic
I’ve shown to get the information
Talking of patients we are already
reaching that point where we will
able to do
he observes us can take to
gas before these images will get the
pocket an agent already has in one pocket
camera that will be able to shoot the
patient listening to the patient it examines the
patient you will have the devices
tools needed by the time the
patient needs us interprets
examinations medical examinations plays one
electrocardiogram we already
You can do already have application
cases that do this you can already
do pathology and in his own mother
we already have algorithms that
We even developed to interpret
Molecular part in sequencing
High capacity
is we managed to do that in my
idea in genomics because I had no
Geneticist the same way that he had a
radiologist then was already creating
scratch no one had expected
a doctor to do it all the time
right then we are we already started with
the tools it is helping us
molecular diagnosis to the doctor
diagnoses and treats medical robots
They will walk a little more but
surgeon who think making apprentice
economy is something that the robot does not
can make waiting 15 years
more than that the issue of
creativity
when Google started to score the
rhythm called alpha goal to play
little game that goal that is a complex game
more complex than
is boring 3 for example and won the
major global players was not
what strikes me calling me
attention was that the best players
world then began attending the
stroked play to learn because he
creative techniques used things
completely new people who
They were playing it for 30 years ever
had thought of my sapo is then
You will start to see creativity
art being created by intelligence
artificial
the peak is going to happen will
be the point is that in the coming years
that will make us realize
as artificial intelligence has evolved and
It will help us because it will make it
there is available accessible to all
world that is when we need
can make the diagnosis right at home
will not be the point of care will be in
home even when we will have this
Here is a device that calls amazon
alex you see talking alexa
I’m not feeling well she will
speak you have you will tell me
‘m feeling that is burning for
I was urinating and urinate several times
today alex will speak measuring
temperature you have no signal
fever or any other
systemic change
so it is very likely that you
has a urinary tract infection will speak
It is that I do treat
Urinary tract infection is a standard fox
signs twice daily for three
days you want us already thinking
this pharmacy and delivered to your home
you say yes you will take after
alex three days will turn to you
talk about life you improved Paulo
improved great you spared a visit
a doctor will only happen more
faster than we imagine what will
happen quickly because in the past
ten years things that have adopted
technology in the last 20 years,
things that have adopted the technology is
were the areas that had decreased
higher cost
people do not have access to medicine
tip that evolved over the past 80
years for the sake of cost by
physical matter to get to the place
all these things will be resolved
That’s what I said
so far what will happen is that
this will continue to grow for some
time but will there will plummet the same
way a course of a television
formerly it was absurd and nowadays is
available in the same way that cell
sometimes you buy for $ 50
is a pharmaceutical is banquinha
so we should be worried about
our doctor job right with our
medical practice
in a sense yes because it will not
have employment that exists today a doctor
there practicing today will not have
this opportunity is in 20 or 30
years has much less room the same
thing happened to the containers in
1956 is an American businessman
He invented the containers
It is a much more efficient way to
to load the ships it took ten years
for it is adopted but when 66
it was adopted worldwide took a
30 times productivity gain
hundreds of thousands of jobs
existed before ship loaders
They disappeared and hundreds of thousands only
in New York
only at the port in New York but these
people were unemployed not what
happened was that these people
They worked before loading the ships
now they had different jobs they
They are working in the transport and all
else that grew all trade
international who grew up with is the
facility and the drop in the cost of
transportation and international trade
so it’s not that you have created a
million unemployed
these people migrated to other
opportunities that have appeared
and it will happen to the doctor
what will happen and so what
Medical back and here is my
final message is one thing we
Europeans should emphasize a technical guy
some emphasized that for many years
and recently discussed with wife
in front of every intelligent woman has
a man is out to get credit is
huh
is he was talking about it
the doctor brings the dentist
behind which a health professional
brings is beyond knowledge is affection
Empathy is a doctor and when
treating a patient in the same way
80 years ago even though it had little to
to the patient
we bring much benefit to the
patient
You have to rescue it
to understand our participation in
world that we are not the guardian of
knowledge
but it is is the best way to
take the patient to a quality
life better for better treatment
thank you
[Applause]
Please follow and like us: