Care starts with the click between doctor and patient
What happens when you combine a deeply rooted interest in technology with a passion for people? Radiation oncologist Gabriëlle Speijer grew up among the technical experiments of her father and developed a fascination for care and innovation at an early age, where innovation for her means more than technological progress. However promising AI, digital twins and data-driven care may be — they only have value if they contribute to the most important thing in healthcare: human connection. “The click between doctor and patient is decisive for the success of a treatment,” Speijer states. She argues for a digital reinterpretation of the Hippocratic Oath and calls on healthcare professionals to take the lead over data and technology. This cover story reflects the conversation with Speijer about vision, trust and the power of real contact — in a time in which healthcare calls for meaningful choices.
Can you tell us something about your background and what led you to immerse yourself in healthcare innovation?
“I work as a medical specialist in Radiotherapy at Haga. That is technically advanced, team-oriented and multidisciplinary. In collaboration with industry, we innovate across domains. From my profession, the focus is on the person within a challenging oncological trajectory. Delivering tailor-made care together with the team is a challenge that I fully commit to. I want to learn from the contact with the patient, gain knowledge and share it. And technology is a very valuable support in that.”
“That interest in technology was, as it were, spoon-fed to me, since my father had technology as his area of focus. He ‘used’ me as a test subject and super user for his technical projects. I then saw it as a kind of guilty pleasure to, for example, connect all devices in such a way and program the remote controls in such a way that only I could operate them. At a certain point, I was about fifteen, I experienced that someone in my surroundings made, in the contact with her general practitioner, a decision that I found strange. The GP left and the person in question then decided to flush the medication that that doctor had prescribed down the toilet, because she could not or did not want to swallow it. That aspect had not come up at all! I found that a waste of the medication and the fact that it was not in favor of the health of this woman. I did not understand why no good connection had been made between doctor and care seeker. That motivated me enormously at the time to want to become a doctor. I thought: I want and must improve this in any case.”
You have updated the Hippocratic Oath. Why was that necessary?
“That has everything to do with the fact that the most central aspect in the work is that you make a connection with your care seeker, whether that is a treatment or an advice or a suggestion. Due to the lack of good safeguarding at the level of ICT and data security, the confidential relationship unintentionally shifts towards a business relationship. This threatens the basis of trust, which is precisely the strength of a good doctor-patient relationship. If that connection succeeds, you get a good picture of the other person. For that, confidentiality is needed. Only then does someone dare to make themselves vulnerable. And that also applies the other way around for doctors. They too need a degree of confidentiality.”
“Sometimes that is quite a challenge, because you do not always just have a click with each other. I then really have to search for that click. If I translate the Oath to the present time in this light, then it means that you say: I promise that I deliver the best care and health to the patient in confidentiality. And digital support is crucial in that. Digital certainty of data: confidentiality, availability and integrity with regard to that digital information or data, is a hard condition. Patient and doctor must have a safe digital environment to be able to gain direct access to the newest technological possibilities. To that end, they must collaborate with the technology developers and the data specialists. Moreover, they must be able to bring in technology, improve it and, if necessary, take it out of circulation when it does not meet requirements.”
“By digitally safe I also mean transparent and testable. At European level we are working on making agreements about this. What is still missing here in my view, is that at global level we can have a framework with principles that are derived from our professional values. Where you, from your role as healthcare professional, client, citizen, technology developer and data specialist, step in digitally, and together manage the data with which technology is developed. I think doctors should take the lead to take that on. It must be arranged at the source, with the doctors and the patients.”
“Such a framework is also partly the key to creating sustainability in the digital ecosystem, because too much cold data is still being stored now, that does not contribute to solving the problem. In fact, it only takes up space and causes noise, insecurity and serious risks to keep the Oath standing.”
Suppose all of this is feasible, what will healthcare practice look like then?
“Then the doctor and the patient, in other words the citizen and the healthcare professional, are in the lead over the technology. The communication is under their control. And because you need a click for that, you must also have a choice, both as doctor and as patient. This should be digitally supported. Because that click is extremely important for healthcare outcomes. That is still underestimated.”
“A hospital is not optimally set up to be able to ‘choose’ a doctor, if the click is not there, but more can be done about this. For example by having a secretariat properly ask the referrer what exactly the care question is, so that they can look for the best match per request. The shortage of staff does not make this easier unfortunately, but perhaps a platform can be created by doctors where they bundle their strengths in this area. That can also be region-wide, and this fits perfectly with that new oath as I advocate it. Because it is about the fact that as a doctor you want to help your patient in the best possible way. If that means that you have to refer him to a colleague in another hospital, for example for a second opinion, then th
