Bolster the “Brilliant Basics” to Enable Future Health Care Transformation

Joe Nicholson, DO – Chief Medical Officer

This is the time of year when people prognosticate. Conversations teem with predictions about what could be. Why not also consider what should be?

Last year, I offered a brief wish list for health care that discussed why we should better integrate social determinants of health (SDOH) and behavioral health into care delivery. I believe those priorities remain relevant. However, as 2024 swings into full gear, I would like to continue the tradition by adding three more “predictive wishes” to my list:

Wish 1: Physicians will exercise cautious optimism about generative artificial intelligence (generative AI)

2024 is shaping up to be a year of exciting health care discussions. Generative AI will dominate many of them. Yet, despite all the talk, our healthcare system is not quite ready to reap all its potential benefits.

There is little doubt that generative AI will eventually transform health care. As of today, though, it cannot be trusted completely. Risks include “hallucinations,” misdiagnoses, patient privacy issues, and data breaches.

I liken the technology to medical students who are incredibly smart and constantly learning, but still need guidance and oversight from practicing physicians who can offer more real-world experience. I think we will always need a combination of humans, well-designed processes, and expertise to solve health care challenges—especially those currently causing physician burnout.

Therefore, cautious optimism will guide physicians’ adoption of generative AI this year. For now, at least, its real-world adoption will be limited to targeted use cases while physicians learn how best to deploy it.

Wish 2: The industry will nudge personalized medicine forward by focusing on the fundamentals

Personalized medicine will also continue to experience more talk than action this year. It, too, has incredible value—consider the personalized therapies that already benefit some cancer patients. Still, we have to be realistic about where our healthcare system stands today. 

Before we can dive deeper into personalized medicine, we must first be capable of extending equitable health care opportunities to every person. That requires us to tackle some fundamental challenges. Specifically, we must:

• Ensure more patients have access to primary care providers.
• Better integrate mental and behavioral health care into physical health care.
• Address SDOH to give everyone the same opportunities to thrive.

None of those things will happen overnight, but I am hopeful that once we nail down these “brilliant basics,” we can start to accomplish our ambitious efforts to achieve meaningful personalized medicine for everyone.

Wish 3: Everyone will continue to champion health equity despite challenges

SDOH and health equity initiatives have gained traction in recent years. However, I worry that they are likely to waver in 2024 as pandemic safety nets dissipate and economic conditions tighten.

The stakes are high, with inflation and economic pressures compelling patients to make tough choices between health care and the cost of living. In the coming year, maintaining our commitment to SDOH and health equity will become even more crucial.

Therefore, we have to actively work against any regression in SDOH and health equity endeavors. To sustain recent strides, we need to recognize the interconnectedness of all of my “wishes” and advocate for the necessary support from government agencies, value-based care contracts, and other entities.

As I contemplate 2024, the long-term prospects for health care are thrilling. Opportunities abound for substantive change, but we must proceed thoughtfully.

I hope we use this year to shore up the fundamentals—the “brilliant basics” that include primary care, behavioral health, and mental health—so that we can eventually reap the benefits of technological and scientific advances. While it is not easy to address health care’s fundamentals, I believe this is the year to roll up our sleeves and set a firm foundation for future transformation.