Stair-climbing just for fun, physicians as friends or doctor’s offices that look more like lounges than sickbays. Futurist Matthias Horx gave this year's European Health Forum Gastein a preview of upcoming trends in healthcare.

Bad Gastein, 6 October 2010 – “´We face massive changes in healthcare.  Not only are we getting older, we continue to make technological progress,” German futurist Matthias Horx said at the European Health Forum Gastein (EHFG). About 600 researchers, policy-makers and scientists from 40 countries have gathered there to discuss the latest developments in the health field.

Horx: “We therefore have to look again at the interconnections. The health sector has seen an upturn in all segments. It has expanded economically and the wellness and therapy products have lent health a genuine style of its own.” He cited the phenomenon of down-aging as an example. Besides living longer, people feel and behave younger than their parents did at the same age. Horx presented seven key trends describing how healthcare might look in the future.

Trend 1: From functional medicine to experiential medicine: Horx: “Much more attention will be paid in the future to what patients are personally feeling and experiencing.” That means the architecture and design of practices will be attuned to the well-being of patients. It also means that what the patients experience symbolically will also play a bigger role. This phenomenon can be seen in studies on pseudo-acupuncture, which was almost as effective as genuine acupuncture. “Experiential medicine means we cannot separate the outcomes of medical treatments from the patient’s culture and the situation,” Horx said.

Trend 2: From complementary medicine to integrative medicine: Traditional Western medicine and complementary medicine are two different medical approaches that Horx firmly believes will merge into fusion medicine in the years ahead. The insight that placebo medicine is also medicine has caused the medical community to rethink the situation. Complementary medicine gains in importance precisely where traditional Western medicine reaches its limits. Ultimately the two schools will merge to form a type of integrative medicine.

Trend 3: From medicine based on making the rounds to medicine based on building relationships: Horx believes the patient-physician relationship will change substantially, from an authoritarian relationship to a friendship.  “Patients want to build a relationship with their physicians,” Horx said citing that as one reason for the rising number of guru doctors and medical coaches: “Patients want a healing friend.”

Trend 4: From the logic of repair to the logic of prevention: Studies show that healthcare systems are hitting the limits of their capability with increasing frequency. In the case of cancer and many other diseases, it is very difficult to enhance the patient’s quality of life and make medical progress. At the same time, the costs and complexity of the system is increasing. Horx noted that patients feel confused and exploited by the system. Personal responsibility will play a bigger role in medicine in the future. There are already trends in this direction. Horx: “The advent of the new culture of active prevention had its origins in the private sector and the number of people belonging to gyms and fitness studios has doubled in recent years.” He then added that government will probably be given the task of intervening with regulations. Examples include the public smoking taboo or the debate about streetlight labels on food.

Trend 5: The message of evolutionary medicine: Evolutionary medicine is a new branch of science. It examines the effects our anthropological heritage has on forms of behavior in modern society and draws conclusions from the lifestyles of ancestors. Already, researchers can group three major diseases under one phenomenon: heart attacks, diabetes and strokes. The only human beings free from these diseases of civilization are tribal peoples, i.e. the proverbial hunters and gatherers. Therefore, medicine must guide people back to their origins. That includes covering long distances in endurance situations, arrhythmic eating, a specific alternation between phases of excitement and relaxation as well as social closeness and coherence.

Trend 6: The nudging system: Problematic patterns of nutrition and exercise result from our desire for compensation. Overeating is comforting; a lack of movement and exercise can be traced to desires to regress and often originates in early childhood conflicts. Methods of punishment are not effective in helping people to learn new patterns of behaviors. Horx cited fees for visiting physician’s offices as an example. They have resulted in people going to the doctor even more than before.  The goal has to be to nudge the public in the right direction in terms of health. That starts with positioning fruit in the right place in supermarkets and extends all the way to the price of mineral water versus Coca Cola in a restaurant.

Trend 7: From more care to managed care: There was a time when health problems were solved by pumping more money into the system. Horx said that those days are over. In the future, the healthcare system has to work more effectively and productively based on innovative approaches to prevention.

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