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The evolving role of physicians in health care

Julien L. Pham, MD, MPH
Physician
November 1, 2022
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Health care has changed dramatically in the last decades, from the introduction of electronic medical records to the COVID-19 pandemic serving as a catalyst for telehealth and virtual care options to the increased familiarity with digital therapeutics, etc. Just as the industry has transformed over time, the physician’s role has similarly evolved.

Traditionally, those of us who attended medical school have had just a handful of career options to choose from after graduation. Becoming a practicing clinician at a hospital or private practice might typically be the first thing that comes to mind. Otherwise, pursuing a career in academia as a clinician, clinician-educator or physician-scientist were the traditional paths for leveraging a medical education.

However, being a physician opens many doors and opportunities once you look more carefully at transferrable skills and knowledge amassed over decades of education and practice. Whether you just graduated from medical school or are looking for a career pivot due to burnout, there are several ways that physicians can leverage their deep medical knowledge to continue to have a powerful impact on care delivery. Beyond joining a health tech startup or a larger biopharma company, there are many ways that physicians are contributing to health care outside of the traditional clinical setting.

Physician investors

As physicians, we have a unique and valuable insight into the clinical mindset and understand the pain points that currently plague care delivery. Many health care workers have been frustrated for years about their daily practice inefficiencies. They may have thought about possible solutions but lacked the time or the expertise to turn those ideas into a commercial product. Those of us with a medical background can play a significant role in investing to identify and support solutions to enable health care staff and hopefully financially back solutions that could improve patient outcomes.

In some ways, my approach to investing is not too dissimilar from my approach to treating patients. I took an oath to “first do no harm” when I entered medical school. As an investor, one is also a steward of capital in the same way a physician is a steward of health. You must take responsibility for what you’re investing in and realize that your decision could harm or protect the lives and livelihoods of patients. One can also think in terms of access to capital and access to care for the under-represented. For example, my background is in nephrology, which is currently an area that is heavily impacted by health care disparities. Black Americans are more than three times as likely to have kidney failure than White Americans, and Hispanics or Latinos are 1.3 times more likely. The most recent report from the United States Renal Data Service shows an end-stage renal disease prevalence of 5,855 cases per million for Black Americans, compared to 1,704 cases per million for white Americans.

While new medications have been introduced to treat kidney disease, few drugs or treatments can reverse the progression to end-stage renal disease. Therefore, it is crucial to explore novel therapeutics to improve patients’ quality of life and possibly cure, reverse or alleviate kidney disease. I am one of the few nephrologists who is also a professional investor. Investing as an angel or in a more structured way — via a VC or PE fund — can have a tremendous impact on the future of kidney care, which is still a blank canvas in terms of innovation. This is just one specialty area where a physician can leverage their background and expertise to identify and accelerate the solutions that will make the biggest difference for other providers and, most importantly, for patients.

Physician mentor/advisor

Physicians can also serve as a mentor or advisor and assist in the development of new technologies or treatments. There is no shortage of startup companies and new ideas circulating. However, to be successful, you need to compile a great team with expertise in a variety of areas. Physicians can play a critical role in advising these companies for organizations that operate in the health care space. In addition, founders should surround themselves with engineers who help design the solutions and businesspeople who can figure out the path to making the company sustainable. It should be a team approach, where everybody works together to improve patient outcomes.

As someone involved in the health care technology space, I always try to do a little bit of matchmaking and rapport-building between experienced health care insiders and founders to create value and accelerate company growth through human capital. Not only is their professional expertise valuable, but bringing people together with different backgrounds, cultures, and experiences provides different perspectives and ideas to the organization, which is ultimately beneficial in making great solutions a reality.

Physician early adopters

There is also an opportunity for physicians to act as care delivery gatekeepers and help to usher in new and cutting-edge forms of treatment, such as digital therapeutics. Digital therapeutics (DTx) deliver medical interventions directly to patients using evidence-based, clinically validated software to treat, manage, and prevent a broad spectrum of diseases and disorders.

Although digital therapeutics has the potential to transform health care, there are multiple challenges for physicians to prescribe digital health therapeutics. Some of these challenges for physicians include:

  • Not being aware of the digital health solutions available for specific patient populations.
  • While they might know about their existence, they might not have the time to incorporate these ever-evolving new digital technologies into their patient care workflows.
  • They might not trust technologies that have only been on the market for a short period of time.

There also needs to be a dialogue between developers (of drugs or new technologies) and physicians, so physicians will feel comfortable prescribing these new treatments, whether prescription drugs or digital therapeutics. DTx products have the potential to address critical gaps in care for underserved populations, regardless of patient age, language, culture, income, disease state, or geography.

Looking ahead

Health care is continuing to evolve, and physicians have an important role to usher in new technologies and forms of care. The path ahead requires a multi-dimensional approach and the cross-fertilization of clinical, scientific, technological, and business disciplines. I envision a future in which physicians will continue to leverage their medical backgrounds in untraditional ways to fuel innovation and create a more equitable health care system for us all.

Julien L. Pham is a nephrologist and health care entrepreneur.

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