Health care worldwide stands at an inflection point, with AI reshaping diagnosis and telemedicine altering the geography of care. In that context, an exceptional group of leaders who are at the intersection of clinical practice, technology, entrepreneurship, policy and investment discussed technology itself and the kind of health care future we want to build in the session 'Looking ahead: The future of medicine'. Moderated by Senior Special Correspondent Kanu Sarda, the panel consisted of Dr H. Sudarshan Ballal, chairman, Manipal Hospitals; Dr Paul Henry, Naruvi Hospitals, Vellore; Dr Ritu Jain, director, Vardhman Medicare; Dr Siddharth Sood, senior consultant, medical oncology/cellular therapies, Fortis Hospitals Limited, Faridabad, and Dr Nitin Kansal, medical director and HOD, cardiology, Santokba Durlabhji Memorial Hospital, Jaipur. Excerpts:
Kanu Sarda/ AI is coming into spaces once occupied only by doctors. What kind of ethical frameworks do we need so that technology enhances, not replaces, patient autonomy and trust?
Dr Sudarshan Ballal/ In this era of AI, technology, computers and robots, let's not forget compassion. That's what I tell my students—use all the technology you can, but don't forget the touch, the feel and talking to the patient. AI has revolutionised reading images, predicting illnesses and analysing large data. AI is here to stay, and unless we adapt to it, we will perish. But AI will never take over the human brain. We will still be controlling it.
Dr Ritu Jain/ AI is a very good guide in the hands of a clinician but can be misused by masses. Sometimes patients come with self-diagnoses that are completely wrong. However, AI is useful for predictive algorithms to diagnose non-communicable and lifestyle diseases. From a gynaecologist's point of view, it's not genetic diseases but epigenetic, transgenerational diseases that will take a toll in the future.
Dr Paul Henry/ The human touch is the most important tool for a doctor. Now, most younger generation doctors are not interested in seeing the patient. The moment the patient walks in, they keep their MRI scan on the table. The doctor looks only at the screen, not at the patient. We've put physician assistants in every room so the doctor can focus on the patient while the assistant handles the screen. AI works more in the back end—diagnosis, statistics, research, data mining and protection. But, it’s getting front-ended when it should remain back end.
Sarda/ Will emerging technologies lower costs or widen the affordability gap?
Ballal/ Whatever technology is available in India should be available to the common man and make treatment more affordable and accurate. Telemedicine became a game-changer during Covid-19. I had patients who would take a week to travel from remote parts of India to see me for half an hour. With telemedicine, I could see them from wherever they were. When Covid was over, patients started coming back, saying they missed me. So while cost and convenience were better with telemedicine, people still wanted to see doctors in person.
Dr Siddharth Sood/ The NHS used AI to solve a £3 billion annual problem by identifying patients likely to default on OPD visits. In India, I don't see technology being used adequately to bridge the gap between rural and urban areas. I fear these players will render their services to high-end urban populations only. I would like to see AI changing the dynamics of screening. India still lacks a dedicated breast cancer screening protocol in 2025—it's unimaginable.
Dr Nitin Kansal/ All new technology is costly because research behind it doesn't happen in India. We need ‘Make in India’ initiatives to bring down costs. The present government is working on this, requiring that at least one part of any technology coming to India be developed here.
Sarda/ Studies show millennials are at highest risk of early-onset cancers driven by lifestyle, environment and genetics. How should India adopt screening and early warning systems?
Ballal/ Indians have been hit hard by diseases affecting the western world without conquering developing world diseases. We have a combination of communicable diseases plus non-communicable diseases. Our emphasis on primary preventive health care needs to be far more than what it is. Sanitation, clean drinking water and vaccination can save millions of lives. We must screen for various diseases much before they show symptoms.
Sood/ Preventive medicine shouldn't start in hospitals—by then it's too late. It should start in schools. I see ultraprocessed foods in my child's school menu. If we don't prevent obesity in childhood, it will follow into adult life with cardiac issues and malignancies.
Jain/ From an obstetric point of view, diseases are transgenerational. There's the famous Överkalix study where unhealthy diet showed manifestations in grandchildren. Optimising female health right from the mother's kitchen and school guidance is crucial. The best prevention strategy is awareness.