Former Surgeon General C. Everett Koop '37 told members of the Class of 1999 that new medical education and technologies will enable doctors to provide better care in the future, putting patients' health over cost cutting and political wrangling.
Koop, speaking last night to a half-filled Spaulding Auditorium about the future of medical reform, focused on changes in traditional notions of health care delivery and education.
He described the U.S. health care system as an institution that is "in grave crisis" and stressed "the ethical imperative for health care reform."
It is shameful that a country as wealthy as the U.S. allows 58 million of its inhabitants to go without medical coverage at some time during each year, Koop said.
Although he promised "no panacea, no secret magic bullet, no easy answers," Koop said a partnership between the government and the private sector can help to rectify the system.
The health-care industry has come under increased fire from public watchdog groups for putting a premium on lower costs and placing patient care on the sidelines.
Koop acknowledged reform was a difficult issue for a democracy to tackle, especially because it requires one part of society to make sacrifices for another.
The demand for highly technical services and trained physicians often conflicts with the need for affordable care, Koop said.
Some modern solutions, such as managed care plans, cut costs at the expense of the doctor-patient relationship and results in lower quality care, he said.
At the same time, the incredible expansion of medical information makes it difficult for primary care physicians to maintain their level of knowledge.
Koop pointed out despite this expansion, students are still expected to master the material in four years.
Koop suggested the work of the College's C. Everett Koop Institute and other groups to revolutionize medical education would lead to solutions for many of the problems of modern medical care.
First, he stressed the importance of the caring nature of the doctor-physician relationship. The Koop Institute has been working to give potential physicians more experience with patients early in their education.
"We need to subordinate [economics] to the climate of trust between doctor and patient," Koop said.
New media technologies also play a crucial role in Koop's vision for 21st-century medicine.
Technologies such as the World Wide Web, virtual reality, video-conferencing and high-definition television can be a boon to both doctors and patients.
Koop said he believes those technologies can give patients more resources and end the intellectual isolation felt by many primary-care physicians.
He said his Koop Institute is pioneering many new uses of existing communications technology, including military devices that were only previously used on the battlefield.
Although many are wary of the multi-billion dollar costs of these media networks, Koop said the economic benefits would far outweigh the costs.
Koop predicted these new tools of medicine will become so prevalent that physicians "will wonder how they practiced medicine without them."
The projects are "too big and too important to be left to either the government or the private sector alone," Koop said.
