The landscape of medicine is poised to look vastly different in the next decade compared to the past, influenced by factors such as technological advancements and the staffing crises exacerbated by the COVID-19 pandemic. Gaining insight into the expectations of future healthcare professionals is crucial for understanding the limitations of existing medical systems.

A recent study conducted by Elsevier Health surveyed over 2,000 students across 91 countries, revealing that a striking 63% of medical students and 59% of nursing students in the United States view their education as a pathway to broader roles in healthcare that do not involve direct patient interaction.

Surprisingly, this sentiment isn't confined to the United States; Indian students echoed this sentiment, with 63% in agreement. In regions like the UK, the Middle East, and Europe, the figures are slightly lower, ranging from 54% to 57%. In contrast, Latin America reported only 37% of medical students feeling the same way, although a comparable portion of nursing students also expressed similar intentions.

This challenge is not merely a US-centric issue, but rather a global phenomenon. One significant factor influencing the outlook of medical students and nurses is the evolving expectations of patients since the onset of the pandemic.

Changing Patient Expectations Post-Pandemic From my experience in urgent care settings from 2018 to 2022, I've observed a significant shift in what patients expect. Initially, COVID-19 deterred many from visiting hospitals due to fear and uncertainty, but it also led to a surge in the use of telehealth, which offered a quicker, albeit less personal, alternative.

The rapid adoption of telehealth was notable during the pandemic. Although it existed prior, its necessity became apparent as patients sought answers while many doctors refrained from in-person visits due to exposure fears. Patients faced a choice: visit the emergency room or opt for a telehealth appointment, which often sufficed to determine the need for in-person care.

Moreover, the modernization of healthcare is increasingly expected in our digital age. A survey indicated that 71% of participants wished their healthcare experiences mirrored the ease of online shopping.

Another study echoed these sentiments, revealing that 98.7% of patients found telehealth convenient, 96.4% noted it saved time, 95.9% considered it an acceptable form of care, and 97.0% felt it improved access. While most still preferred in-person visits (62.6%), 86.9% regarded telehealth as equivalent to traditional consultations.

Mia Levy, MD/PhD, reflects on these changes, noting that "almost overnight, asynchronous communication has become the norm, and patient expectations have shifted dramatically. Post-pandemic, patients anticipate their doctors to be perpetually available for inquiries, seeking swift responses. While this digital healthcare model offers convenience and efficient resource management, it has also placed immense pressure on providers to meet these demands."

She highlights the rise of over-the-counter diagnostic tests, as patients became accustomed to ordering their own tests, often for reassurance rather than necessity.

While this can empower patients to understand their health better, it also poses challenges. There's a risk of unnecessary testing, leading to further procedures, and the influence of misinformation complicates matters.

The Role of Misinformation and Eroding Trust The initial erosion of trust in healthcare can be traced back to inconsistent messaging from authorities regarding COVID-19. Conflicting information about masks, treatments, and vaccinations has contributed to low adherence to proven medical guidelines.

A friend of mine, Dr. H, left his ICU position due to PTSD triggered by the pandemic. He recounted an instance where he was pressured by a patient's family to administer ivermectin, despite knowing it was ineffective. He reflected, "I cannot practice medicine when families dictate treatment based on misinformation, undermining years of training dedicated to patient care." He has since transitioned to a role in the pharmaceutical sector.

The loss of dedicated professionals like Dr. H represents a significant setback for the field. Throughout the pandemic, he faced the emotional toll of comforting patients in their final moments while families could only connect via devices. Over time, he found himself explaining why popular beliefs based on internet narratives did not align with evidence-based medicine.

Misinformation continues to proliferate, often propagated by influential figures. Recent comments by Elon Musk during an interview exemplify this issue, leading to confusion about the realities of medical treatment.

Given the vast audience that such figures command, healthcare professionals struggle to convey accurate information. With limited interaction time during patient visits, contrasted with the extensive reach of disinformation, the challenge becomes more pronounced.

Rising frustration among patients, fueled by misinformation and access issues, has led to increased violence against healthcare workers. Examples include incidents of gun violence against medical staff and physical assaults on nurses, as well as online harassment related to political views.

Conclusion The combination of pervasive misinformation, violence, and declining trust among patients is pushing many healthcare students away from direct patient care. However, this trend is unsustainable. The current healthcare system is increasingly dominated by corporate interests, leading to concerning health outcomes at exorbitant costs.

Patients are already experiencing delays in finding primary care providers, with wait times extending up to nine months, contributing to the growth of urgent care clinics operated by large corporations.

A sense of urgency for change is evident, and healthcare students are raising alarms about the future of the industry. It is crucial that we heed their concerns before it is too late.