An interview with Dr. med. Thomas Wüst, specialist for orthopedics and sports medicine
The key task of an orthopedic surgeon is to promote the development of the musculoskeletal system and to treat degenerative conditions. This task remains the same in times of digital solutions, although increasing use is now being made of new technological options. What those options are, why it’s important to educate people, and how patients and physicians stand to benefit from emerging forms of technology were just some of the questions TRANSFER magazine asked the #techourfuture expert Dr. med. Thomas Wüst.
Hello, Dr. Wüst. Can we start by asking why you think it’s important to keep society informed about future technology?
You can’t do away with fears, reservations, preconceptions, and people rejecting useful and relevant medical technologies of the future if you don’t provide objective information. You have to clearly formulate and communicate the meaning and purpose of using them. People will only start to trust future technology if they’re kept informed, they’re educated, and they’re offered transparency. It’s important to clearly show the benefits for people, patients, and society as a whole.
Speaking as a physician, an orthopedist, there have been major advancements in orthopedics over the last 20 to 25 years, especially in technological terms. And that’s why it’s always been important to deal with certain reservations and certain fears held by patients by talking about things. We will continue to experience huge leaps forward in technology in the future, due to digital transformation and artificial intelligence. So it will become all the more important to allay people’s fears and to clearly show them the opportunities this offers. We have to explain in plain terms why we’re doing what, and the consequences this will have. The other important aspect is that as physicians, new technology saves us time so we can invest this “bonus time” in patients. I’m lucky in that I run my own practice, precisely because I want to give that time to patients. But patients generally spend an average of three to five minutes in the orthopedist’s consultation room. During this time, we should go through medical records, conduct a clinical examination, and if possible even make a diagnosis, which if you’re realistic is pretty difficult. This is where new technology could help us as doctors, but it also means that we need to invest time and effort to ensure we’re familiar with this technology. But ultimately this does save us time, because for example we can be specific and provide quick information on our assessment or diagnosis – time we can invest in patients. And this raises patient satisfaction. It also makes treatment successful, because patients have trust in the physician and this leads to a good physician-patient relationship.
To consult patients properly, you need a good understanding of the very latest status of technology. How do you integrate that into your work if your day is already full, especially as a doctor with his own practice?
This is a really exciting topic. It is indeed a greater time investment, especially at the beginning, but looking back, overall it takes up less time. To work, a doctor needs effective structures and, extremely importantly, a good and motivated team. Your co-workers should enjoy trying out new things. We’ve just hired a sports scientist who’s already spent time looking into artificial intelligence, which is helpful for everyone in the team.
It’s important to make proper use of the interests and knowledge of every individual in the team. I believe that if you think together as a team and work across different disciplines, that already solves lots of problems. Working as an individual, I can only really manage a small part of the picture. Things really do work better as a team – and quicker.
What prejudices toward new technology do you hear about in the course of your work?
I think lots of prejudices and fears about this topic have something to do with the concept that medicine can be something cold and alienating. These times are already fast-moving, and then the doctor spends much too little time going through medical records and conducting an examination – to save time. It’s quite common for medicine to be accused of being mono-causal or only about symptoms. If you then add the fear that in the future, doctors will allow themselves to be “driven by machines,” people have major reservations and the doctor-patient relationship starts to break down.
This is another area where it’s important to educate patients. Many patients are worried about the high costs of technological diagnostics, which are not met by the insurance companies; from my experience this is unnecessary, and if anything the opposite is true. Compared to other European countries, German patients are known to be more critical when it comes to new technology. This also seems to have something to do with the lack of connections between different services. We have to make it clear to patients that doctors will still be crucial and irreplaceable in the future, and by using new and efficient technology they will have more time for patients.
One thing we already do in my practice is to use the options offered to us by telemedicine. It’s of paramount importance for the patient that you have an efficient approach to therapy. Digital solutions, telematics, and electronic patient records enable us to obtain and interpret information about patients anywhere we need to, in real time, and discuss this with different contacts. The recent pandemic has fueled this development because there’s a greater willingness among the population to try out telemedicine due to current circumstances. But also in areas with a weaker infrastructure, where doctors are in short supply, telemedicine offers us an opportunity to keep the healthcare system running. Despite this, patients should always be given the choice of organizing a telemedicine session or speaking to somebody face to face. Naturally, telemedicine also has its limitations and that’s something everybody needs to be aware of.
Another important issue when it comes to reservations is data privacy, although some good solutions have now been thought up for this. Of course patients initially have concerns when doctors look at their records. It’s important to explain to them that they decide which doctors should be allowed to see their records. Another point I find extremely important in this context is electronic patient records. Patients can keep their information with them all the time – on all factors that are relevant – and this gives them more freedom to decide themselves.
Which new technologies in the field of health and medicine would you use yourself?
All of the things I just mentioned have an impact on me, too. If I’m a patient myself, I always try to get into direct contact with a doctor’s office, with the people there, to establish a relationship of trust.
Something I personally find fascinating is the possibility of using digital technology – or to be more specific artificial intelligence – to make even more accurate diagnoses.
We’ve been working with the Fraunhofer Institute in this area to use AI solutions to evaluate gigantic volumes of data with the specific aim of understanding a certain algorithm. We’re dealing with patient records here, so it’s important to explain to patients how information is being used, so they give us their consent and ultimately allow us to use their data.
Something that really interests me is analyzing movements of the human body from a holistic standpoint. This allows us to show how people move around when they walk – without having to X-ray them: the back, the position of the pelvis, leg joints, and footprints moving together in synchrony. This allows you to look at complex interactions and evaluate them accordingly. And this is exactly where we also want to use artificial intelligence: Doing something like this involves unbelievably large volumes of data, which we previously interpreted by relying on our experience, and we had to invest a huge amount of time just for this part of the process. In the future, evaluating this information will become more insightful, accurate, and quick. It will be a holistic method that can be used on an interdisciplinary level. The process will show upward and downward influences on posture. Dentists and orthodontists will also play an important role. And the feet will be important, as well as the eyes and the inner ear. There are so many medical specialists involved in such an analysis. I find that incredibly exciting.