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The future of general practice: consulting in the Metaverse

Richard Armitage is a GP and Public Health Specialty Registrar, and Honorary Assistant Professor at the University of Nottingham’s Academic Unit of Population and Lifespan Sciences. He is on twitter: @drricharmitage

If you spend even a small amount of time online, have the vaguest interest in contemporary technology, or enjoy books and films of the sci-fi genre, then you’ve probably heard of the term ‘Metaverse’.

While it was first coined by Neal Stephenson in his 1992 anarcho-capitalist themed digital dystopia, Snow Crash, it wasn’t until 2021 when use of the word ‘Metaverse’ became a central feature of the digital zeitgeist. The sudden popularisation of this misunderstood term was undeniably sparked by Facebook founder and CEO Mark Zuckerberg in his July 2021 declaration that ‘… in this next chapter of our company [which includes, beyond Facebook, Instagram, WhatsApp, and Oculus VR], I think we will effectively transition from people seeing us as primarily being a social media company to being a metaverse company’,1 and his subsequent announcement in October 2021 of the technology conglomerate’s name change from Facebook to Meta.2

Google Trends reveals that search interest in the term ‘metaverse’ increased by at least two orders of magnitude between January 2021 and January 2022 (Figure 1), with ‘the metaverse’, ‘what is the metaverse’, and ‘metaverse meaning’ constituting the three most commonly searched queries.

Figure 1. Google Trends data pertaining to search interest for the term ‘Metaverse’ from January 2004 to October 2022. Numbers represent search interest relative to the highest point on the chart for the given region and time. A value of 100 is the peak popularity for the term. A value of 50 means that the term is half as popular. A score of 0 means there was not enough data for this term.

Following Zuckerberg’s announcement, the term ‘Metaverse’ almost became a punchline for technology companies while their executives scrambled to explain why, by incorporating it into their business plans, it would make their firms more profitable, their customers more satisfied, and their rivals less competitive.

But the hype wasn’t merely restricted to the West, as Eastern corporations, such as China’s largest company, Tencent, revealed its metaverse vision in November 2021, and South Korea’s Ministry of Science and ICT announced the South Korean Metaverse Alliance, which includes over 450 companies.3–5

But, as the Google search queries plainly reveal, the public’s understanding of what the Metaverse is, what it does, how it works, when it will be here, and how it will affect individual lives, is deeply unclear. In this article I will offer basic answers to these questions, before offering my vision of a typical general practice consultation that could take place in the Metaverse.

What is the Metaverse?

While there is no official or even widely-accepted definition of the Metaverse, the following captures most of the relevant features that are broadly considered to be its essential components:

‘a massively scaled and interoperable network of real-time rendered 3D virtual worlds that can be experienced synchronously and persistently by an effectively unlimited number of users with an individual sense of presence, and with continuity of data, such as identity, history, entitlements, objects, communications, and payments.’5

The Metaverse will exist within the infrastructure of Web3, which is a catch-all term to describe the next iteration of internet functionality that is decentralised, permissionless, and trustless, and contains key features such as blockchains, cryptocurrencies, and non-fungible tokens.6

“… the public’s understanding of what the Metaverse is … is deeply unclear.”

There is also no consensus on when the Metaverse will arrive, as many significant barriers stand in the way of its construction including current limitations of networking, computing, virtual world engines, interoperability, hardware, and payment rails. However, current trends in the development and uptake of technology suggest a functioning Metaverse may be only a few years away.5

Culturally popular depictions of the Metaverse, including Snow Crash, Ready Player One (Ernest Cline’s 2011 novel and Steven Spielberg’s big screen adaptation in 2018), and The Matrix franchise, all constitute dystopian worlds in which participants escape (sometimes unknowingly) the horrors of their realities by plunging into the hedonistic free-for-alls offered in digital paradise. However, rather than a sanctuary to escape to after fleeing the real world, the in-coming Metaverse will provide a place in which what happens in real life (IRL) can also happen in the digital realm, and in some cases be enhanced beyond what is possible IRL, including in education, business, and entertainment. In addition, I foresee health — in particular the functioning of frontline primary care — being radically disrupted and completely transformed through its delivery in the Metaverse.

A typical general practice consultation in the Metaverse

A few minutes before my first appointment I move to a quieter spot on the beach with ample Metaverse connectivity and space to move around in. I pull on my haptic gloves and VR headset — which allow me to feel with my hands whatever I digitally palpate, while receiving fully immersive visuals and audio, and sending real-time video of my face and voice — and log in to my digital surgery.

My consulting room appears exactly as I’d left it, containing digitally rendered equipment in a clean and orderly environment. I pull up my settings menu and select today’s outfit — a crisp shirt (brilliant white), blue chinos (contrasting belt), and brown brogues (immaculately polished) — which instantly bedecks my avatar while I don swimming shorts IRL.

“… Metaverse will provide a place in which what happens in real life can also happen in the digital realm … “

I open the digital record of my first patient of the day. This decentralised packet of information, which is entirely owned by the patient, was shared with me via an encrypted link when the patient booked the appointment, and now takes up my entire visual field as I scroll through its contents using hand gestures.

Once I’m prepared to consult, I simply say ‘ready’, and a notification immediately appears in the patient’s visual field — ‘Dr Armitage is ready to see you, relocate to the surgery?’ The patient — wearing similar gear to myself (full capability headset but whole-body haptic suit) — is logged in to the Metaverse and is currently in a work meeting, but swiftly makes his apologies and renders in the waiting room.

I walk along the corridor to collect the new arrival, as my headset augments the digital surgery atop my IRL surroundings, and feel the warm Thai sand under my feet instead of the surgery’s hard floor (deliberate choice to avoid haptic socks).

I greet my first patient and he follows me into the consulting room. I offer him a hand shake and I feel his firm grip (haptic gloves working), while we exchange pleasantries and make eye contact (visuals and audio working) as we settle into our chairs.

I then take a history from the patient sat before me. The cameras and microphones embedded in his headset provide a high-fidelity real-time video stream into my own immersive experience so that his facial expressions, vocal tone, and eye movement are as clear and insightful to me as they would be IRL.

“… current trends … suggest a functioning Metaverse may be only a few years away.”

When it becomes time to examine his abdomen and chest, his whole-body haptics and those covering my hands allow me to palpate the troublesome lump that he subsequently reports as tender. My digital stethoscope streams the noises captured by his suite (which contains microphones over his chest) directly into my ears through the speakers in my headset.

When we’re sat down once again, I explain the differential diagnoses, send an encrypted prescription to the patient’s preferred pharmacy (that can only be collected with the encryption key I provide), and arrange IRL investigations along with follow-up in the Metaverse.

He thanks and bids me farewell, before instantly relocating to his meeting at work. I select ‘dictate’ on my heads-up menu, record my clinical findings, and add the audiorecording and the haptic palpation data to his decentralised medical record. This I repeat for all my day’s patients, who could be located anywhere, both IRL and in the Metaverse.

While this vision may not manifest in its entirety, it is extremely unlikely that general practice will not be changed, in some meaningful way, by the arrival of the Metaverse and all it will have to offer. At least for me, it promises an exciting opportunity for the evolution of general practice.

References
1. C Newton. Mark in the metaverse. The Verge 2021; 22 Jul: https://www.theverge.com/22588022/mark-zuckerberg-facebook-ceo-metaverse-interview (accessed 17 Oct 2022).
2. Q Wong. Facebook renames itself Meta amid controversy. CNET 2021; 28 Oct: https://www.cnet.com/tech/services-and-software/facebook-renames-itself-meta-amid-controversy (accessed 17 Oct 2022).
3. R Liao. Tencent shares its metaverse vision for the first time. Tech Crunch 2021; 11 Nov: https://techcrunch.com/2021/11/11/tencent-metaverse (accessed 17 Oct 2022).
4. The Korea Times. Korea launches ‘metaverse’ alliance. The Korea Times 2021; 18 May: https://www.koreatimes.co.kr/www/tech/2021/05/133_308975.html (accessed 17 Oct 2022).
5. M Ball. The Metaverse: and how it will revolutionize everything. New York, NY: Liveright, 2022.
6. Ethereum. Introduction to Web3. 2022. https://ethereum.org/en/web3 (accessed 17 Oct 2022).

Featured photo by Muhammad Asyfaul on Unsplash.

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