Advances in health tech could send “worried well” into hyperdrive, warns leading surgeon

New technologies such as wearable health devices and sensors, advances in genomics, and DNA testing, alongside a proliferation of personalised health information, could send the “worried well” into hyperdrive, the Chair of the Royal College of Surgeons’ Commission on the Future of Surgery has warned. 

Speaking ahead of the IDEAL International Conference 2018 in Bristol (13 & 14 September), at which he will be presenting on the Commission, Mr Richard Kerr, has said that NHS services will need to be geared towards supporting patients overwhelmed by the vast amount of individualised health data that will soon be available. 

The Commission, which is due to publish its final report in the autumn, will caution that while new technologies will offer better opportunities to diagnose and treat patients before their illnesses become severe, there is also the potential for them to cause patients unnecessary alarm. 

Explaining how the “worried well” will need to be supported, Mr Richard Kerr, who is also a Consultant Neurosurgeon and Royal College of Surgeons Council member, says: 

“Right now, most patients see their doctor when they fall sick or unexplained symptoms prompt them to seek medical advice. However, very soon there will be an immense amount of health information available to patients, whether through data recorded by personal wearable devices and sensors, or a greater understanding of our genetic predisposition to future illnesses. 

“The “worried well” will be sent into hyperdrive. GP practices and A&Es will undoubtedly see more patients who are concerned about what this information means for them.  

“Better early diagnosis is good news for patients. Prevention, or early intervention, is always better than cure. That said, the NHS will need to be ready to handle an influx of patients with potentially valid concerns about their risk of falling ill in the future.

“There’s already a plethora of information available on the internet which doctors are used to answering questions about. However, as new technologies advance, the NHS will need to be geared towards supporting patients who might be confused and scared by the vast amount of individualised health data that will soon be available.

“As health professionals, we will need to help patients navigate this proliferation of information and provide tailored support so they can understand their risk of illness, as well as their treatment options, should their concerns lead to diagnosis.” 

Mr Richard Kerr believes that more widely available genetic testing could see the nature of operations carried out by surgeons change. He says:

“For surgeons, advances in genetic testing could mean having to carry out more prophylactic or preventative surgery.  

“We all recall the “Angelina Jolie” effect. One study1 showed that referrals for genetic testing more than doubled in the months following the actress’s decision to announce she had been tested for the BRCA1 gene and subsequently undergone risk reducing mastectomy. It’s easy to see a future where as genetic testing becomes more widespread, individuals who are found to be at risk of genetically associated cancers, will expect preventative surgery. Advances in genomic medicine will also allow us to offer more personalised treatments.

“Surgeons will have a key role to play in explaining the benefits, risks and limitations of different types of DNA testing and assisting patients in the decision making process. There will also need to be changes to NHS services to support these types of patients through their genetic counselling, testing, diagnosis and treatment options.” 

Mr Richard Kerr adds that there is a risk that some patients will be offered treatments they do not require:

“Medical professionals will also need to be vigilant to the risk of misdiagnosis and overtreatment that this proliferation of personalised health information could bring. There is unfortunately the danger that the unscrupulous of our profession could prey on the fears of patients, convincing them that treatment is necessary, where it is not. 

“The Commission will advocate for a shift towards more multidisciplinary work and decision-making to try prevent this sort of thing from happening.”

The Commission on the Future of Surgery aims to set out a compelling and credible vision of the future advances in medicine and technology, as well as how those developments will affect the delivery of surgical care. Experts on the Commission panel have sought to understand developments in minimally invasive surgery, robot-assisted surgery, nanotechnology, radiology and imaging, artificial intelligence, genetics, oncology, 3D printing and planning, regenerative medicine, pharmacology, and anaesthesia.

Notes to editors

1. The Angelina Jolie effect: how high celebrity profile can have a major impact on provision of cancer related services: https://link.springer.com/article/10.1186/s13058-014-0442-6 

2. The Royal College of Surgeons of England is a professional membership organisation and registered charity, which exists to advance surgical standards and improve patient care.

3. For more information, please contact the RCS Press Office: telephone: 020 7869 6047/6052/6229; email: pressoffice@rcseng.ac.uk; for out of hours media enquiries: 07966 486832.