A Physician-Free Future
The Arrogance of American healthcare
I want to invite you to my new podcast -
I interview founders and CEOs changing the way we develop, validate and deploy treatments. I take a business perspective and a hard look at their value proposition, value creation and value capture of the company.
Last week I wrote about a Pharma-Free Future and took a deep dive into the perverse incentives of the $60BN/year drug development industry,
Today - I’ll challenge you with a Physician-Free Future.
The arrogance of power
"Power tends to confuse itself with virtue and a great nation is particularly susceptible to the idea that its power is a sign of God's favor, conferring upon it a special responsibility for other nations—to make them richer and happier and wiser, to make them, in other words, more like itself. If God has a chosen people, whose theology is it that insists they must prevail over all others? This is the arrogance of power."
— J. William Fulbright, The Arrogance of Power
The global life sciences and health tech industries are dominated by the U.S. model of intensive, high-cost medical treatment.
Startups in pharma-tech and health tech feed off the economic power of this model, reinforcing a belief that American medicine is the gold standard. American economic power breeds arrogance—the belief that the American approach must prevail, despite mounting evidence that it is neither sustainable nor optimal for longevity or quality of life.
In this essay, I’ll present empirical data and common sense that challenge this model.
Our families, our communities, and our own bodies can thrive without excessive dependence on physicians and drugs.
Within the next 7-10 years, the Western world will transition to a physician-free future. Three forces will drive this shift:
The rise of the Internet of Bodies (IoB)
Changes in the education system
The end of the primary-care physician and the rise of the nurse
The Internet of Bodies
The IoB—connected wearables, implantables, and body-proximate sensors—is generating unprecedented volumes of data. By 2025, over 41 billion IoB devices will be streaming 2.5 quintillion bytes of data daily, encompassing biometrics, geolocation, and behavioral insights.
Unlike traditional electronic medical records (EMRs), which rely on intermediaries and transcription delays, IoB data is immediate, fresh, and directly linked to the patient’s biology and behavior.
This surge in data will enable AI-driven diagnostics and treatment recommendations that far surpass the capabilities of human physicians.
The Future of Work: AI and Expertise destroys SaaS
AI is not only disrupting medicine—it’s reshaping the entire landscape of work.
The $1.3 trillion SaaS industry will collapse in the next 5-10 years. Businesses will find it faster and cheaper to build their own CRMs in days rather than paying Salesforce $1,200 per year per employee.
AI-assisted coding is democratizing software development, shifting massive amounts of wealth away from VC-backed SaaS and toward individual experts who can build AI-driven solutions for themselves and other businesses.
For life science professionals, this shift presents an opportunity to escape the rigid structures of corporate employment. The most fulfilled executives I know are building businesses that serve their lives—not their bosses.
4 hours of focused work daily
No micromanaging bosses
No endless email chains
No organizational politics
Just the freedom to do what you do best, with the people you love most.
The key? Learn how to code with AI.
In the next 13 months, we will witness a massive shift of wealth from VC-backed enterprises to individuals with expertise.
Want to turn your expertise into freedom?
Invest 15 minutes
The Rise of Apprenticeship, the Fall of K-12
As job creation slows and expertise trumps resumes, the education system will undergo a transformation.
Modern K-12 education was designed during the Industrial Revolution to mass-produce factory workers.
Mass-production replaced the apprenticeship model, which had sustained human knowledge for centuries with mass-produced education.
During the Middle Ages, apprentices learned under masters, acquiring not only technical skills but also moral and social education.
With AI automating knowledge-based work, the master-apprentice model will return.
Masters will teach young apprentices work and life skills.
Masters will work through their 70s and 80s and beyond and use AI to develop tools for their shop.
The combination of masters, apprentices and AI tools will have a profound impact on how we live, how we take care of ourselves, our parents and our children.
For the master-apprentice system to thrive, masters must remain healthy.
Apprentices have vested interest in their masters' well-being.
This incentivizes preventive health, physical resilience, and community-driven longevity,
We will eat well, move well and take care of our elders well.
Longevity by Lifestyle
The future of health is not in hospitals but in communities.
“Blue Zones” like Okinawa (Japan), Sardinia (Italy), and Ikaria (Greece) demonstrate that exceptional longevity can be achieved with minimal medical intervention. In Okinawa, residents have 80% lower rates of heart attacks than Americans—largely due to diet, movement, and social engagement rather than pharmaceuticals or clinical treatments.
Sardinia’s mountain villages have ~33.6 centenarians per 100,000 people—double the U.S. rate. The key? They stay physically active, eat well, and maintain strong social bonds.
Empirical data from Blue Zones vs. Western healthcare highlight a crucial insight: modern medicine excels at treating disease, but longevity is driven by lifestyle, not physician intervention.
The fall of the physician, the rise of the nurse
AI-driven diagnostics are rapidly approaching—and in some cases exceeding—the accuracy of human physicians.
AI-powered triage assistants already match physician performance in diagnosis.
Deep learning systems in pediatrics outperform junior doctors in identifying common childhood illnesses.
Despite these advances, human doctors still hold an edge in complex diagnostic reasoning.
However, the bulk of primary care—routine check-ups, minor ailments, and chronic condition management—can be handled by nurse practitioners (NPs) at equal or greater efficiency.
As AI replaces physicians, we cannot give up on the human touch.
General human-level capabilities of sight, touch, movement, manipulation, and coordination are more than 20 years in the future—if not more.
Nurses are a far more accessible, cost-effective, and human alternative to bots.
Decades of research confirm that NP-led care matches or surpasses physician-led care in quality, cost, and accessibility.
A Physician-Free Future
The U.S. healthcare system, a $15 trillion machine of perverse incentives, is not a healthy model for the future of our health.
The fee-for-service system rewards overutilization, leading to $75-100 billion in annual waste from unnecessary treatments.
Pharma and health tech startups are built on sick-care economics, prioritizing profit over patient well-being.
The Blue Zones prove that physicians and drugs are not prerequisites for long, healthy lives.
The convergence of the IoB, master-apprentice shops, and nurse-led care makes a physician-free future inevitable.
If you care about the future of your own body, your family, parents, children and community; stop and think about your life choices:
Should your life science/healthtech venture serve healthy families and communities?
Or something else.
Is there anything else?
Sources
A Comparison of Artificial Intelligence and Human Doctors for the Purpose of Triage and Diagnosis
The Pediatric AI That Outperformed Junior Doctors
Quality of Nurse Practitioner Practice
Journal of the American Medical Association (JAMA) Publishes Humana Study on Health Care Spending
A few words of thanks
❤️ To my readers, my love and gratitude for reading my work. If you’re not a subscriber, now would be a great time to support my work.
I want to invite you to be a guest on my new podcast - “Life Sciences Today”.
If this piece got you thinking, you’ll love my new podcast. In my first episode, I dove into AI’s role in accelerating clinical development with Orr Inbar from Quanthealth.
Once a week, I host people changing the life science industry in drug development, clinical operations and real-world data.
👉If you’d like to be a guest on the show - let’s talk!
👉 If you enjoy reading this post, feel free to share it with friends! Or feel free to click the ❤️ button on this post so more people can discover my writing. 🙏