How doctors see the future

Elsevier’s Clinician of the Future 2023 report shows readiness to embrace generative AI across the global healthcare industry. The company’s Tim Morris answers questions arising from the survey.

Why did Elsevier Health launch the Clinician of the Future 2023 report and how is it different to the previous one?

Elsevier Health’s Clinician of the Future program, which was launched in 2022 with the original report, serves as a pulse on the state of the global health ecosystem in the eyes of doctors and nurses.  

One year later, we have kept our commitment to clinicians and launched the Clinician of the Future 2023 report as the most current pulse on what doctors and nurses think about the challenges and future opportunities in healthcare, including an additional lens on artificial intelligence (AI). 

So this really continues and emphasises our pledge to listen to the voices of healthcare professionals across the globe, which we set out following the launch of the inaugural report. 

Role of AI

This new report champions the experiences and voices of 2,607 doctors and nurses worldwide.

While it underscores the gravity of healthcare workforce challenges highlighted in the original survey, like nursing shortages, the latest report puts an additional lens on the future role of generative AI in healthcare and its implications on patient care and health outcomes.

It found almost half of all healthcare professionals are eager for doctors to utilise generative AI in the future to support their clinical decision-making, further affirming the need to drive a technological shift in healthcare.

We conducted this survey of nurses and doctors, including consultants and GPs, to hear their views and to help see the world from their perspective. 

Giving a voice to their concerns and their recommendations will help create an industry roadmap for action, which is especially important as we look to evaluate and understand how AI can positively impact healthcare. 

 

What priorities have doctors and nurses identified that will influence care in the next two to three years?

The first Clinician of the Future report identified that most doctors and nurses anticipated growing staff shortages. 

These shortages are now having a significant impact on the frontline workforce in many regions, and, as a result, it has been identified as the number-one concern globally in the 2023 report. 

The shortage of nurses ranked top on the list of priorities to be addressed over the next two to three years, as 54% globally selected it as a top priority. But we are now seeing concern grow about shortages of doctors as well. 

Forty-five per cent of respondents globally consider the growing shortage of doctors as a top priority to address. 

In the UK, the shortage of nurses and doctors were ranked as the top two priorities.

Another top priority for the global healthcare workforce was improving their continuous training, as a total of 49% globally consider this a priority for the next two to three years. 

Managing public health was also a prime concern, with 46% highlighting this as a significant area of worry. 

Ongoing inequities in the healthcare workforce and the impact it might have on patient care was another priority for many doctors and nurses. 

Twenty-four per cent of respondents consider encouraging greater diversity in the healthcare workforce to better represent the local population a pressing issue in the next two to three years.

Generative AI has transformative potential in healthcare. How can this technology be used to support doctors and nurses and what needs to be done to enable adoption?

Front-line staff see an imminent need to be experts in using and prescribing digital health technologies. 

Over the next two to three years, 73% said doctors having more expertise in digital health technology will be more desirable. 

One promising area of potential for generative AI highlighted in the report was to aid clinical decision-making. While only 11% of today’s clinical decisions are supported by generative AI tools, almost half (48%) of respondents agree that in the next two to three years doctors should use such tools to help make clinical decisions. 

Interestingly, China was the most optimistic about generative AI adoption, with 53% expressing doctors using such technologies in the next two to three years is desirable, compared to the US (42%) and the UK (34%).

There is also appetite to understand how AI can aid administrative and time-consuming tasks to support patient care and free up clinician time. 

We are excited about how these new technologies can drive further innovation and efficiencies, and ultimately help improve patient outcomes.   

We can also see that many doctors and nurses across the world support the notion of utilising AI to train medical and nursing students. 

Over half of all doctors and nurses globally welcome the prospect of medical students using generative AI-powered tools as part of their medical education in the next two to three years. However, this is significantly lower in the UK (33%). 

What are the key challenges and opportunities facing doctors and nurses in the future?

In this year’s survey, we found that both the UK and US agreed tackling the nursing shortage is a top priority in the next two to three years. 

As part of the shortage issue, we also saw an increase in the percentage of respondents considering leaving their roles in the next two to three years compared to our previous report. 

Of the total 37% who said this, 24% plan to move to another role in healthcare, while 13% plan to leave healthcare altogether, either by moving to a non-healthcare-related job or retiring.

We also saw a trend towards patient empowerment, as doctors and nurses expect the health literacy and proactive health management of patients to grow in the next five years. 

With new technologies like wearables, clinicians are confident patients will take on a larger role in their own health, impacting the expectations and subsequent relationship between doctors and their patients.

Front-line healthcare professionals believe that two in five of their patients are health literate today, but believe this will rise to half of patients by 2028. 

Those surveyed also said while only 38% of patients take an active role in the management of their health and 27% use monitoring tools to assess their well-being today, they expect this to rise to 49% and 45% respectively within five years.

What doctor and nurses training needs should be addressed in the next two to three years to truly transform the clinician-patient relationship?

The Clinician of the Future 2023 report found that the Covid-19 pandemic has had a significant impact on the training of the newly graduated workforce. As a result, newly trained healthcare staff are perceived to be unprepared for clinical practice. 

The report found two-thirds of practising healthcare professionals globally believe newly graduated clinicians lack hands-on practical training, as they were not able to physically attend education throughout the pandemic. 

Taking into consideration the workforce shortages and the lack of hands-on training, it is vital that steps are taken to support the transition into practice. 

As I’ve already mentioned, many of those surveyed recognise the potential of generative AI and large language machine-learning models to support training. But they stress that these technologies should be an adjunct and not a replacement for face-to-face learning experiences. 

The response to the potential of AI is divergent, with some considering it as a threat to necessary hands-on experience, while others are concerned it may teach inaccurate or erroneous information while hindering critical thinking and decision-making.

As a leader in healthcare technology focused on training the next generation of doctors and nurses, Elsevier feels it is vital that training needs to be elevated at all levels of healthcare to fully engage in innovative technologies meant to alleviate the clinical burden and ultimately improve patient care.

The report revealed doctors and nurses have a positive sentiment towards value-based care. What do you think is driving this, including considerations around the implications for private practices?

The concept of value-based care is not new, and although it is not yet a broad reality in most countries, some are moving towards it and doctors and nurses generally see this positively. 

In the previous report, we outlined how a growing and ageing population was expected to drive change across healthcare systems. 

Accelerated population ageing will have an impact on the prevalence of non-communicable and age-related diseases, making a new approach to healthcare even more urgent. 

As such, the concept of moving away from a transactional pay-per-service approach to a more holistic, efficient, preventive and patient-centred one is growing.

From this year’s report, we can see that most doctors and nurses expect value-based care to reduce the burden on secondary care, as 73% expect most patients to be managed in primary care settings. 

We also see that they believe this shift will improve the patient experience, with 69% expecting hospital stays to be shorter as a result, while only 51% said value-based care would save costs. 

The fact that nearly half did not expect cost reductions demonstrates the challenges in achieving this outcome across all patient populations at scale. 

Realising systemic cost savings will require overcoming initial growing pains as new models are implemented.

While doctors and nurses recognise the importance of this shift, they ultimately think there is still a journey ahead – 74% think more should be done in preventive care, while 40% consider personalised treatment approaches a top priority. 

This indicates many providers see room for improvement in how holistic, proactive care is delivered and funded.

What actions does the wider healthcare sector need to take to help address the challenges facing doctors and nurses of the future?

This report paints a dynamic picture of the current state of healthcare, and as new doctors and nurses enter the workforce, the landscape will continue to shift. 

The wider sector should continue to listen to front-line healthcare professionals, including those on their way to qualification, to hear their views and to see the world from their perspectives. 

With those insights, we can continue to develop solutions that help them deliver the best possible care for their communities.

We have played a role in healthcare at Elsevier by supporting doctors and nurses for more than a century. 

We recognise the challenges they face, their concerns for the future and we also see the opportunities there are to support as they navigate them. 

And we have actively supported healthcare professionals for more than a century. We recognise the challenges they face, their concerns for tomorrow and the role we can play in helping them to navigate the opportunities of the future.

We are excited about new technologies like generative AI and large language machine-learning models, as they can drive further innovation and efficiency to help future-proof healthcare systems. 

By combining our industry-specific human expertise, in-depth trusted content and high-quality data and generative AI technologies, we can work with healthcare professionals to help enhance patient care.

Tim Morris (right) is a former A&E nurse and vice-president of clinical solutions at Elsevier Health