As it does every year, Apple revealed its new gizmo lineup in early September.
 
This year’s “Glowtime” event spotlighted the new iPhone 16 series, the Apple Watch Series 10, and the AirPods 4, along with camera upgrades, and a new IOS 18 operating system which integrates “Apple Intelligence” — that’s Mac-speak for “AI” — into the new generation of devices.
 
Apple’s offerings evoked a rather jaded yawn from the tech world. No new desktops, laptops or iPads, no major redesigns to get excited about. The gizmo-savvy set seems unimpressed by Apple’s first foray into onboard AI, and the consensus seems to be that the new lineup offers incremental improvements, alluring perhaps for those who simply must have “the latest,” but non-essential for everyone else.
 
Likewise, Wall Street responded with a big “Whatevs.” The new product launches had negligible impact on Apple’s stock price or ratings. 
 
From a healthcare perspective, though, Apple’s 2024-2025 pitch tells an interesting and important tale.
 
The new devices are packed with health and fitness-related features. The Apple watch includes an ECG feature that can detect atrial fibrillation and alert users to the need for rapid medical attention. It can monitor sleep patterns and detect obstructive sleep apnea — a common and serious cardiovascular risk factor. It can ID a woman’s time of ovulation by tracking subtle changes in her wrist temperature. Its motion sensors can tell if an elder has a sudden fall or accident.
 
And of course, the new watches and iPhones can host an astonishing array of self-tracking and biohacking apps.
 
What really caught my attention is the fact that the new AirPods Pro can be used to detect hearing loss, and if needed, transform themselves into clinical grade hearing aids.
 
“The World Health Organization estimates that more than 1.5 billion people are living with hearing loss,” said Dr. Sumbul Ahmad Desai, vice president of Apple’s Health division, during the September launch event. “If left unaddressed this can affect your short- and long-term health, including increased risk of cognitive decline, falls, and social isolation which contributes to depression.”
 
She added that, “a staggering 75% of people diagnosed with hearing loss haven’t received the assistive support they need.”
 
That’s in part because conventional hearing aids are costly, and the audio quality of many of them isn’t all that great. With its new AirPods Pro 2 selling at $249, and packed with audiometric features, Apple aims to solve this problem.
 
Paired with an iPhone, the system offers a simple, clinically-validated, 5-minute hearing test that users can take at home. Apple says the test has been verified against the gold-standard of pure tone audiometry. The app then creates a personalized hearing profile, which users can store in the Health app, track over time, and share with their practitioners. 
 
If needed, the AirPods Pro can function as customized hearing aids, “boosting the specific sounds you need in real time, like parts of speech or elements within your environment. This will allow you to hear your surroundings better, to help keep you safe, and connect you with people nearby,” explained Desai.
 
She added that the system is built on data the company has gleaned from the Apple Hearing Study, a massive collaboration with the University of Michigan that involves more than 160,000 participants living their lives out in the real world. 
 
OK, by now you’re probably saying, “But, Erik, I work for a supplement company, and Nutraceuticals World is a magazine about the nutrition industry. Why are you rambling on about Apple?”
 
The point here is that we’ve got a tech company that is: A) invested heavily in healthcare; B) doing medical research; C) creating a novel, less expensive, more convenient, direct-to-consumer solution to a very common health problem; and D) marketing that solution in a way that completely leapfrogs over a segment of medical professionals — in this case audiologists — which up until now had a strong lock on a specific set of medical problems — in this case, hearing loss.
 
If you look around, you’ll see plenty of other examples of this sort of leapfrogging.

Skipping the Line … to the Consumer

Many types of services and products once obtainable only through practitioners are now available DTC. The shift of healthcare out of doctors’ offices, clinics, and hospitals and into peoples’ daily home, work, and retail spaces has been going on for the better part of the last decade. And the momentum is only increasing.
 
People can now get their genomes analyzed for the price of a steak dinner. Microbiome test kits are available in retail pharmacies and myriad online outlets, and there are plenty of online options for analysis and interpretation, all without involvement of a physician. 
 
Last year, under the guidance of functional medicine thought leader, Mark Hyman, MD, a company called Function Health emerged with a comprehensive bundle of more than 100 sophisticated biometric tests, selling direct to health-conscious wellness consumers for just $499. There is, for sure, a practitioner component to Function’s business model. But a quick glance at the company’s website shows without doubt that Function’s primary objective is to engage non-practitioner customers.
 
There are now DTC options for risk assessment for an ever-widening number of disorders. The FDA has approved several at-home screening tests for different types of cancers, as well as DTC tests to detect HIV. A host of discrete DIY tests for other sexually transmitted diseases have also hit the market in recent years. 
 
And let’s not forget Covid. In response to the pandemic, some highly sophisticated virological tools moved out of medical academia and into the medicine cabinets and kitchen counters of ordinary people with astonishing speed. So common are Covid test kits now that we easily forget just how revolutionary — and how esoteric —polymerase chain reaction (PCR) technology was when it first emerged.
 
Though there’s not (yet) a direct-to-consumer Covid vaccine, the FDA did just approve a self-administered version of AstraZeneca’s FluMist influenza vaccine nasal spray. FluMist, which contains attenuated live flu viruses, has been on the market since first approved in 2003. But until now, it had to be administered by licensed medical practitioners. Not anymore. FluMist still requires a prescription, but people can self-administer at home.
 
It’s a safe bet that we’ll soon see other types of self-administered vaccines hit the market.

Convenience Care

Covid also pushed telemedicine to the forefront of modern healthcare. The number of practitioners now offering remote consults, and the number of patients accessing them, has grown at a spectacular pace over the last 4 years.
 
A joint survey of more than 1,100 healthcare practitioners undertaken by my company (Holistic Primary Care) and Nutrition Business Journal last year showed that 58% of respondents routinely offer teleconsults. While most of these practitioners are still seeing the majority of patients in person, 23% reported that virtual visits accounted for 80% or more of their practice’s total visits. 
 
Generally speaking, practitioners are happy with telemedicine: 45% of our respondents said they’re “very satisfied” thus far, and 41% are “somewhat satisfied.” Only 14% were dissatisfied with their telemedicine experiences so far.
 
Teleconsults will never entirely replace face-to-face clinical encounters, and there are many things that simply cannot be done remotely. But there are lots of things people can do on their own, or with remote guidance. There’s no question that virtual visits have obviated the need for many in-person visits.
 
The proliferation of walk-in clinics has, for many people, shifted the locus of routine medical care away from physicians’ practices, and into the retail milieu. Though the retail medicine world has gone through some gnarly gyrations recently — exemplified by Walmart’s decision in April to shutter its in-store primary care clinics in five states — the convenience care model is here to stay, in one form or another.
 
From so many vantage points, it is clear that we’ve rapidly moved away from the old highly-structured model in which practitioners and clinics were the nuclei of healthcare, to a new and fluid model in which patients/consumers themselves are the central focus.
 
In a sense, this is the full-flowering of the “empowered patient” trend that began in the 1960s with the “alternative” medicine movement, and which accelerated 20 years ago or so, with the expansion of the internet.
 
It’s hard to remember, but there was a time when medical research was only really accessible to practitioners, researchers, or people who somehow had access to medical libraries. That was certainly the situation when I started my medical journalism career in the 1980s. With few exceptions, ordinary people had neither the inclination to read and evaluate clinical research nor access to the literature. Today, it’s a whole different story.
 
By choice or by necessity, many more people are now “taking responsibility for their own health.” The tech sector, diagnostic testing world, and the supplement industry are happy to facilitate this.
 
But the trends beg some important questions: What is the role of practitioners in peoples’ lives today? What are the limits of self-care? What does the practitioner-patient relationship look like in a world transformed by mobile devices, remote consults, and myriad AI assistants?
 
We’re all going to find out on the fly. But what we can say clearly now is that the medical clinic is no longer the center of the healthcare equation like it was in the past: the patient — aka the consumer or “end user” — and his or her smartphone is now the point of focus.
 
It is obvious that practitioner channel nutraceutical brands recognize these trends and have joined the leapfrog party.
 
Twenty-five years ago, when we first launched Holistic Primary Care – News for Health & Healing, there were dozens of supplement companies that were strictly practitioner-only. With a few exceptions, their products were unavailable in retail channels. People had to go to naturopaths, chiropractors, or holistic MDs to get them.
 
By 2010, online retail had thoroughly disrupted that cozy ecosystem. “Channel leak” is what we called it: unauthorized online resellers acquiring stockpiles of practitioner brand products and selling them DTC on Amazon and other platforms, usually at lower prices than practitioners who dispense supplements.
 
After a decade of playing whack-a-mole to eliminate or at least contain the problem, most practitioner-only brands have come to accept the hard truth that people love convenience and low prices. Like it or not, these companies have developed their own DTC retail strategies, whether online, brick-and-mortar, or both. 
 
Currently there are only a handful of companies that remain true pure-play practitioner-only. And those stalwarts are realizing that they must do more than provide top-quality supplements; they must also provide support tools to help their practitioners maintain relevance in a rapidly changing socioeconomic landscape. 

Public (Mis)Trust

In truth, Americans have a rather schizoid love-hate relationship with medical professionals. On one hand, “Doctor-recommended,” “Clinically proven,” and variants of such language are among the most common tags marketers like to put on their products. And that’s for a good reason: though public esteem for the medical profession has been seriously tarnished over the decades, most people still see practitioners as skilled, knowledgeable experts, and they want clinical “blessings” on their supplement choices.
 
Yet, several recent consumer surveys suggest that public trust in medical practitioners is at an all-time low.
 
At Nutraceutical World’s recent Health and Longevity Conference & Showcase in New York City, market research consultant Carly Fink, founder and CEO of Provoke Insights, noted that only 31% of consumers surveyed said they seek advice about health, wellness, and supplements from medical professionals. By contrast 49% are getting their advice from social media, and 47% from friends and family members.
 
And in a recent survey of more than 2,300 U.S. consumers by Pure Branding, 29% of respondents said their trust in the medical system has decreased in recent years, while only 19% said their trust has increased. Pure’s data showed that the number of people who view the medical system as “Seriously flawed” or “Extremely corrupt and harmful” has increased from a combined total of 22% to 34% in the years since the pandemic.
 
Concurrently, 58% of Pure’s cohort said their “desire to take charge of my own health” has increased.
 
In an insightful blog post earlier this year, Pure’s founder Yadim Medore noted that the Covid pandemic “created a more critical and informed supplement consumer. Whether they actually are more knowledgeable or not, they think they are.”
 
It’s clear that a lot of people are ambivalent about practitioners and the systems in which they practice. Yet most, especially if they’re dealing with serious diagnoses, still turn to practitioners for guidance. It’s only a small segment of self-educated biohackers that is willing to go at a serious illness all alone.
 
And let’s face it, despite the proliferation of DTC tests, tools, and products, there are still many tests, treatments, and services that can only be obtained from qualified practitioners.
 
So, it’s safe to conclude that practitioners — and by extension, the practitioner channel for the supplements industry — will remain an important part of many peoples’ lives for the foreseeable future. But the nature of the patient-practitioner relationship, the technologies that mediate that relationship, and the dynamics that influence a person’s purchases are all in flux right now.
 
Executives who want their brands to remain viable in the medical space need to pay close attention to all of these trends.
 

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About the Author: Erik Goldman is co-founder and editor of Holistic Primary Care: News for Health & Healing, a quarterly medical publication reaching about 60,000 physicians and other healthcare professionals nationwide.