What we are talking about here is the replacement of medieval models of medical care, which rely on quaint and frankly obsolete notions such as the
patient-physician relationship, with an evidence-based, data-driven, information-rich, and leaner approach to healthcare. Plus it will be crowd-sourced,
enabling participants to take full advantage of peer-to-peer education and evaluation. In effect, it can turn the waiting room into a treatment room, fully
capitalizing on the wisdom of the crowd.
Once medicine was physician-centered. Now medicine will be truly patient-centered, with us the patients in control of where we receive care, how the care
is delivered, who delivers it, and what care we receive. Patient dissatisfaction with physicians and hospitals will become a thing of the past, since there
will be virtually no physicians and hospital to be dissatisfied with. The triumph of MOOH seems all but inevitable, like a tsunami of technology rolling
across the nation's healthcare landscape.
Of course, the change in our healthcare business model will be profound and irreversible, spawning unexpected benefits. For example, as costs plunge toward
zero, healthcare providers will no longer need or even be able to compete on costs. No longer treated as commodities, they will compete strictly on the
basis of quality, and the excellence of U.S. healthcare will necessary rise at an ever-quickening pace. Only the very best will be able to survive.
Inevitably, some problems will arise. For one thing, a small number of backward patients will still want to see and be seen by their physicians in person,
just as a few Luddite students still insist on attending classes with live professors. Some accommodation will need to be made, at least temporarily. On
the bright side, however, the fact that such patients will be receiving care in an outmoded and discredited model should hasten their demise and speed the
universal proliferation of MOOH.
A second problem concerns procedures that cannot be delivered digitally. For example, some patients will still need broken bones set and inflamed
appendixes surgically removed. When such circumstances arise, however, procedure centers operating on a self-service basis will be available, much like a
quick oil change. Patients will simply schedule the procedure on line, present at the appointed time, and then undergo the procedure with a minimum of
wasteful human interaction.
Finally, there is the problem of time and effort. While physicians and other health professionals will be relieved of a great deal of work, the burden will
shift to a large extent to patients. Like the MOOC student, MOOH patients must devote time and effort to healthcare, into whose pilot seat we will now be
thrust. Happily, however, this should not be much of a problem, since it will be our own life and health on (the) line, which should provide more than
In sum, we stand at the precipice of healthcare's promised land. The New York Times declared 2012 the "Year of the MOOC." The time has come for
the nation's patients and physicians to declare 2013 the "Year of the MOOH." To facilitate the unification that will be necessary, it would be helpful to
have some symbol to rally around. To capitalize fully on the bovine analogy, may I suggest as the logo for robust MOOH the image of a strapping golden