Digest from John Mauldin's Weekly E-Letter

Silicon Valley (or its virtual space at Harvard, Rice, the Hutch in Seattle, and Stanford, plus a whole world of scientists) is getting ready to do the same thing to medicine.

What happens when you go to the doctor today? He uses a stethoscope to listen to your heart, looks down your throat and ears, and asks you questions. These were all 19th-century technologies, with some minor updates. X-rays? 80 years or more ago.

Medicine today is focused on fixing what ails you. If you have heart problems, let's put in a stent or repair a valve. Lipitor to help control your cholesterol. Chemotherapy to deal with your cancer, if we can't cut it out.

In short, we spend $1.5 trillion just in the US on trying to fix what goes wrong, and precious little on preventing things from going wrong. Health-conscious people try to eat right, exercise, take supplements, have regular check-ups, and avoid things that are bad for us; but if there is a problem, we go to the doctor to get it fixed.

That is going to change, and it is going to change at an even faster pace than did our cellular phone service. It will come one innovation, one small step at a time; but in 10 years, 15 at the outside, we will be more focused on preventing illness than fixing it.

Your front-line doctor is going to be displaced by technology. It is going to be one of the most massive disruptions in history. We all know how bank tellers have been basically replaced by ATMs. There are far fewer bank tellers today, and the ATMs are open 24 hours.

But as a species, bank tellers were relatively few. Not so with medical professionals. They are a huge part of the economy. And many of them are just as endangered as bank tellers. (If you are in the health care business, read on. The news gets better.)

How does all this happen? Early detection, and then "fixing" the problem before it becomes a problem.

First, let's get rid of heart attacks and strokes. Late last century, we began to get scanning technology that was a single slice per rotation. Then it went to 4. Then in 2002-03 we saw scanning that went to 16 slices, by 2005 it was up to 64, and this year we find scanning machines that can do 256-slice rotations. We can start to see some really small parts of your body. Combine that with imaging software and doctors can start to see what's wrong with you.

But we are not small enough yet. By the end of the decade, that scanner will be at 1,024. Recognize this progression?

2-4-16-64-256-512-1024...? Does it sound like the number of transistors in a chip or the size of your computer memory? Or the speed of your computer? Or any number of things that Silicon Valley views as engineering problems?

It will not be long before they can "see" the plaque building up in your heart or veins. Long before it would be a problem. And running hand in hand with this technology is the work being done to develop drugs and targeted therapies which will remove the plaque.

Right now, scans are expensive. We don't usually get one unless there is a problem. But in the very near future, those scans will be able to give you a very early warning signal about heart problems. And while in the first few years it will only be those people who can afford or whose condition dictates an expensive scan, the cost will come down. Think cellular phones.

Within ten years, a regular part of your check-up will be a full body scan. Yes, I know that full body scans have a bad reputation. And deservedly so at lower resolutions. But that will change as they become much higher resolution, as well as relatively cheap and ubiquitous. Certainly cheaper than letting a problem build up.

But it will not just be hearts and plaque. Soon, a database will start building a real map of what a body should look like. We will know the body far better than Gray's Anatomy, down to the cellular level. The computer will start spotting irregularities and bringing them to the attention of your doctor. Tumors? Weak bones? Build-up of beta-amyloid in the brain (a form of plaque), which causes Alzheimer's? Let's fix it before it becomes a problem. (By the way, the Japanese may have developed a DNA vaccine for Alzheimer's which could be in human trials in three years.)

The higher the resolution, the more we can see. And you can count on the resolution getting to a very, very fine scale. It won't be Dr. McCoy's handheld Tri-Corder for a long, long time. But in 10-15 years it will do the job just fine. The usual suspects for bringing on heart disease, attacks, and strokes are going to be detectable at an early stage. They will soon be under our preventative control. Given the huge amount of money spent on these diseases, plus the great amount of suffering, this will be a major sea change.

What is it worth to avoid a heat attack or stroke? Not just to the individual, but to the insurance company or Medicare?

Right now, nature is a brutal screen for the expenditure of health dollars. You have to get sick to get someone to spend money. Very little is spent on prevention.

Last year, I went to see Dr. Mike Roizen at the Center for Partnership Health in Chicago (https://centerforpartnershipmedicine.com). I saw five doctors and two health-care professionals in one day. Very organized, yet somehow I did not feel rushed. They all took their time. They probed and prodded and did every rude thing they could. It was as high-tech a preventative program as there is anywhere in the country. I highly recommend it for busy professionals.

(Mike is the author of RealAge and YOU: The Owner's Manual. He is on Oprah and everywhere else I turn. It is hard to get someone better than Mike when it comes to trying to live as long and as healthy as you can.

In reality, what I did was go to Mike and say, "See if you can find anything wrong." Six test tubes of blood (some 200 odd blood screens and tests) and a lot of probing later, they said it looks fine. It was the latest and greatest you can do.

In ten years, we will look back and see this as the equivalent of rotary dial phones. It won't even be seen as the equivalent of six-pound cell phones. They will start with the scan, and then the doctors will really be able to look at my body. From the inside out.

I guess I should say the stress test and heart scan did indeed allow them to look at my heart. In ten years, though, they will be able to get a stop-flash color image down to almost the cell level.

If there is a problem, then we can do some real prevention. Order up some plaque remover, please. Let's look at that small spot on your gall bladder.

Every few years for the next 10 years, I will go back and they will be able to find more and do more. It will not be cheap, but it will be cheaper than getting sick. And the cost, like cell phones, will come down as the quality of service goes up.