What if Dr. House Used Twitter?

A talk with Dr. Bertalan Mesco, the Medical Futurist

Bertalan Mesco is an MD and PhD who has established a global reputation as a medical futurist. His mission is to fill the gap between healthcare and digital technologies. He is also very much a proponent of treating the patient as a customer. We were intrigued by his focus and the things he expects for healthcare, and asked him some questions about—what else?—the near future. He made some anticipated points—the effects of which we are already seeing—and some surprising predictions as well.

HS&M: What medications—or treatment areas—would have advanced the most, and why (current areas of discovery, profit potential, etc.)

BERTALAN MESCO: It seems that those medication areas that are supported by highly engaged, empowered patients could advance the most as patients can significantly contribute to that. Examples include diabetes management with continuous glucose monitoring systems or spotting atrial fibrillation as a risk for stroke with smartphone-connected ECG devices.

HS&M: What will a patient’s—sorry, customer’s—life be like: what will wearables measure, how much will we depend on telemedicine, how much will we monitor our own health?

I, as a patient, want to be the point-of-care. Wherever I am or whenever I need them, I want diagnostic and treatment options.


HS&M: What patients today can (or worse, are allowed to) do about managing their health and disease is ridiculously far from what technologies can provide them with. The patient life must change dramatically. First, I as a patient, want to be the point-of-care. Wherever I am or whenever I need them, I want diagnostic and treatment options. Second, I want to get engaged, as my life is at stake. The era of hero physicians is over. No physician can be up-to-date when there are 30 million studies out there. We need disruptive technologies that take care of repetitive tasks that do not require the attention of a person but let us talk to each other to nourish the human touch.

HS&M: How will pharma/bio/device companies change, in terms of how they market or sell?

Markets will become less essential and patients will go through different types of healthcare systems (of different countries) to get the help they need

MESCO: I think they will have to shift their focus from treatments to prevention. Prevention requires at least as many innovations, technologies and products as treatment does but preventing diseases is much more cost-effective for healthcare in general than treating what is already out there. As the ivory tower of medicine is breaking down, and access to anything from treatments and technologies to information and second opinion becomes global and digital, markets will become less essential and patients will go through different types of healthcare systems (of different countries) to get the help they need.

HS&M: What will the HCP’s day be like: mostly in virtual contact with patients, less or more time spent online and filling out forms, sources of information?

MESCO: If we cannot remove 100% of administration from the physicians’ life, we are doomed. Medical students will leave after the first glimpse they get of their future job that involves 60% of their time spent on administration that could be aided or replaced by a few not even futuristic technologies. If digital health can reach its full potential, physicians will have a very creative job that involves all their unique skills from problem solving to empathy. They will have the time and focus to deal with a few cases that really require their attention in person. The rest can be dealt with through digital channels. This way their reimbursement and performance both become transparent.

HS&M: Will the team approach—between various physicians, companies, payers, etc.—be enhanced so that the patient is better served?

MESCO: This has been a main theme of improving healthcare for decades. What the multi-disciplinary approach misses, I think, is involving the team of the patient, too. Patients have a team including their pharmacists, patient advisors, advocates, online communities, peer support and of course, family. We will experience no change in practicing medicine as long as patients are not equal members of the medical team.

HS&M: Will we be able to improve on such things as cost containment, adherence, risk prevention?

MESCO: Health sensors and smart apps patients can use at home can help a lot with risk prevention from stroke to diabetes complications. Digital pills that add a microchip to the medication* can help a lot with adherence in certain mental health conditions. In others, empowered patients don’t have an issue with adherence (I think the term is even offensive to them) as they perfectly understand why they need that treatment. Regarding costs, disruptive technologies are only disruptive if they are cheaper than any technology before them. Related to more complicated issues such as personalized medicine, it’s the responsibility of policy makers to realize that customization of treatments is more expensive today, but more cost-effective in the long-term as those help avoid side effects and re-hospitalization.

*See our coverage of Otsuka’s digital breakthrough in this issue.

Bertalan Mesco

The Medical Futurist

Bertalan is a self-described geek physician with a PhD in genomics and an Amazon Top 100 author. He envisions the impact of digital health technologies on the future of healthcare, and helps patients, doctors, government regulators and companies make it a reality. With 500+ presentations under his belt, including courses at Harvard, Stanford and Yale Universities, Singularity University, and organizations including the 10 biggest pharmaceutical companies, he is one of the top voices globally in healthcare technology. He has been featured on CNN and the BBC, in WIRED, National Geographic, Forbes, TIME magazine, and the New York Times, and was on the Future Health Top 100 list. His blog has more than 3 million readers, and he is one of LinkedIn’s Top Voices. He is the founder of, the first service that curates the medical and health-related social media resources free of charge for patients and medical professionals.


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