The Robot Will See You Now

Near the end of “The Empire Strikes Back,” after Luke Skywalker has had his big confrontation with Darth Vader in the battle where he loses his hand (and also learns that Darth Vader is his father), we see the aftermath where Luke receives his new hand.

It’s only a brief snippet, not the full surgery, so we don’t know that many details about the operation itself. But it seems clear that this was probably not done by an orthopedist or a hand surgeon who just happened to be on that spaceship, but most likely by a robot. A robotic hand is seen testing sensation and movement in Luke’s fingers, and then closing the operative site.

We can only imagine that off in the future, as space exploration continues and expands, we will not have a specialist for every potential surgical need on every spaceship out there fighting to overcome the evil empires of the universe.

Space medicine is a fascinating subject, and how we as a society plan to address these things as we continue to explore the moon and beyond is the subject for another day (imagine the first appendectomy or C-section on a Martian settlement!).

Right now, robotics are starting to find their small place in medicine, and while there are some really interesting examples out there, and there may be some opportunities, there probably won’t be that many of them joining us in primary care in the first wave.

Recently I’ve begun some new collaborations and work projects with some of our technology-focused experts, looking at artificial intelligence, smart systems, virtual and augmented reality, and even robotics, and how they fit into the healthcare system of today and of the future.

When we think about how robots have fit into our society thus far, the best examples are probably in the manufacturing industry, where robots can efficiently and safely stand in for human beings to perform repetitive tasks, such as assembling, soldering, and manipulating parts on an automotive assembly line. There’s not much in healthcare that works quite like that.

Some of the best examples in medicine, such as the Da Vinci surgical robot, stand in for a surgeon who may be across the room, or across the country, manipulating surgical instruments with extremely fine precision movements in tight confined spaces. And there are really cool examples of folks working on microscopic robots that may enter a space that we can’t get into in the human body to perform surgical repairs or deliver medications or chemotherapy. But for the foreseeable future, I don’t see this transforming the world of outpatient medicine, or primary care in particular.

We recently had a workgroup where people came together to try and think of ways to incorporate robots into different healthcare settings, and many of the ideas ended up being about delivery robots that bring supplies to a procedure room, or robots that provided counseling and updates, or other rote tasks that could replace a human being and help make things more efficient. Probably not the most efficient use of a machine that can cost upwards of $100,000.

Robotic technology may not be what we need in healthcare in the field of outpatient primary care, although perhaps a medical assistant that is there to bring you supplies for a procedure, or assist during a laceration repair or a Pap smear, might be some ways we could think about using this type of technology.

Better than a robot for us would be a smart system that helps us get all the getting done that our patients need. Perhaps it could be a home robot, or some avatar on the patient’s home computer, that collects data from their remote patient monitoring and helps them see the results when they stick with their diet, take their medications, and exercise daily. Or something that reminds them to take their medications every day, that tells them it’s time to check their blood pressure and then helps them get it done. Or something that assists with home physical therapy, that does wound care and dressing changes, and maybe even assists with fall prevention and prevention of decubitus ulcers in bedbound patients.

While I don’t think that we’re going to get to a robot or any other system replacing a physician any time soon, there is room around the edges to think creatively, to build up a better system that helps our patients get and stay the healthiest they can, even when they’re not in our office or in direct communication with us. Implementing a set of smart systems and devices that helps our patients take their medicines or maybe even picks up their prescriptions at the pharmacy for them, or makes sure they do their mammograms or go to the gym, could go a long way toward building a better and healthier society.

Maybe that’s not as exciting as a robot that can give you a new hand after it’s been chopped off by your father, but maybe, if we let ourselves be creative, innovative, and thoughtful, we can find ways to get more done for our patients.

R2-D2 and C-3PO will see you now.

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