What Will Healthcare Practice Look Like in the Future?
In a small room aboard a space station orbiting above the deep blue of the Mediterranean, a physician floats, secured to the ceiling by a flexible strap. He presses the button on an IV pump — gravity pulls nothing downward here — then carefully removes air bubbles that have no natural path upward. He fixes an ultrasound probe inside a transparent dome designed to keep drops of gel from drifting away like tiny pearls in the air.
He speaks to a colleague, also suspended by a harness, and gestures toward a patient secured to a bed tilted at a 45-degree angle. Hydration. Calculated intravenous magnesium. Continuous monitoring through an artificial intelligence system that reads the tracing in real time. The software learns from every heartbeat. Yet the final decision remains human — in hands that know when to act and when to wait.
The physician gently pushes himself toward the observation window. Below, the Arabian Peninsula passes in a breathtaking view between the Red Sea and the Arabian Gulf. From above, everything looks unified — clear, without borders. He pauses, records notes on a mounted tablet, leaves a voice message for the ground team, taps the patient’s shoulder with quiet reassurance, and floats away.
It sounds like a scene from science fiction. In reality, it may represent the future of healthcare beyond Earth. As space missions accelerate and more countries pursue orbital stations — and even settlements on the Moon or Mars — the field of space medicine is already taking shape.
BioGravity
In recent years, Saudi Arabia has taken bold steps in space exploration — not only by sending astronauts into orbit, but also by launching research initiatives that could reshape medicine and life sciences. Among the most notable is the BioGravity project, introduced by the Saudi Space Agency as a research platform dedicated to studying life in microgravity — an environment fundamentally different from Earth.
BioGravity represents the first specialized scientific community in the Kingdom focused on microgravity research. Its goal is to empower scientists and researchers to develop innovative space-based studies.
Microgravity refers to the condition experienced by astronauts in orbit or during spaceflight, where objects appear weightless.
The project also aims to build a new generation of Saudi researchers capable of leading future studies. Through partnerships with local and international universities and research centers, BioGravity serves as an open laboratory linking the Kingdom to the global scientific community. It places Saudi Arabia at the center of international competition in this promising field.
The core idea behind the project is simple, yet potentially transformative. On Earth, gravity influences every cell and organ in the body. In space, that force is reduced to almost nothing.
This change allows scientists to observe biological processes from a new perspective. How do cells grow without gravity? How does bone structure change? Can the immune system function at the same level? And perhaps most importantly: how can healthcare professionals practice medicine under such complex conditions?
A Different Kind of Medicine
Space is a harsh environment. There is microgravity, cosmic radiation, confined living spaces, and isolation from Earth’s resources.
Each of these factors alters human physiology. As a result, medical practice must adapt in fundamental ways.
Microgravity, for example, directly affects the musculoskeletal system. Without weight-bearing activity, bones lose mineral density at a rapid rate, increasing the risk of fractures. If an astronaut breaks a bone in space, will it heal normally?
Research conducted on animals and cells suggests that the absence of mechanical load disrupts bone healing at the cellular level. Beyond fractures, astronauts often experience back pain as spinal discs expand without gravitational compression. Muscle loss — especially in the legs and back — is also common.
Nearly every internal system behaves differently in space. Cardiovascular changes are among the most noticeable. In microgravity, blood does not pool in the legs but shifts toward the head. Astronauts initially develop what is known as “puffy face, bird legs” syndrome. Over time, the body eliminates excess fluid, reducing blood volume and easing the workload on the heart.
The heart itself, being a muscle, can shrink because it no longer needs to pump blood upward from the lower body.
Digestive and metabolic functions also change. Without gravity, astronauts may experience bloating or constipation. Gas does not rise naturally in the stomach, making even simple acts such as burping unexpectedly complicated.
More concerning are changes in liver and kidney function. The risk of kidney stones increases due to mineral loss from bones. Calcium enters the urine and may crystallize into stones.
Endocrine function can also be affected. Some astronauts show signs of insulin resistance. If a person with diabetes were to travel to space, managing insulin could become more complex. Absorption may change, and blood samples behave differently in microgravity if not handled carefully.
Currently, astronauts are selected for excellent health. Conditions such as diabetes or hypertension are typically excluded. But as space travel becomes more common, future travelers may include individuals with chronic diseases requiring treatment.
It is not unrealistic to imagine insulin pens carried to Mars, or blood pressure managed in a lunar or Martian settlement with limited supplies of salt and medication.
To prepare for this future, researchers are studying how medications degrade in space. Many drugs have shorter shelf lives due to radiation and storage challenges. Dosages may need adjustment. Supply limitations must also be considered. There is no pharmacy nearby for refills.
All of this suggests that if space medicine becomes widely taught in universities — or recognized as an independent specialty — major changes will be required in medical education. There will be space-specific physiology, diagnostics, and pharmacology that differ from what is practiced on Earth.
Surgery in Space
Perhaps no area of medicine will require more specialized practice — and more specialized training — than surgery. On Earth, gravity keeps a patient’s organs relatively in place and allows blood to pool downward.
In space, internal organs may shift. If the abdomen is opened, the intestines could literally float. Blood would not fall onto the operating table. Instead, it could form spherical droplets that drift or scatter in all directions, creating dangerous contamination inside the cabin.
These realities make traditional open surgery highly risky in microgravity. So far, no astronaut has required major surgery in orbit. This is partly due to strict medical screening before launch. However, studies estimate that during a deep-space mission with a crew of six or seven, at least one surgical emergency is likely to occur over several years.
Astronauts could develop appendicitis, gallbladder attacks, or even organ rupture — conditions that on Earth demand a fully equipped operating room. How would surgeons respond millions of kilometers away from home?
Researchers in space medicine are preparing for such scenarios. Experiments have already shown that surgery in microgravity is possible, though far from simple. Surgeons have practiced wound suturing, small vessel repair, and even forms of laparoscopic surgery on animal models in environments such as the International Space Station.
These tests have led to creative innovations. Surgical instruments can be magnetized so they attach to trays instead of drifting away. Both the patient and the astronaut-surgeon must be secured with straps to maintain stability during delicate procedures.
The procedures themselves would also change. Minimally invasive surgery, using small incisions, would likely become the standard. Smaller entry points prevent organs from floating freely and limit the release of blood into the cabin. In one recent experiment, a research team successfully simulated the control of abdominal bleeding in microgravity conditions through small incisions.
Researchers have also developed inflatable surgical enclosures — bubble-like operating chambers. Transparent plastic domes with arm ports can cover the patient’s torso, preventing blood droplets from escaping and contaminating the spacecraft.
Robotic surgery systems are expected to play a major role. Surgeons on Earth could control a dual-arm robot remotely, or the robot could operate in a semi-autonomous mode supported by artificial intelligence.
Robotic surgery offers clear advantages in space. A robot does not tire. It does not experience stress. It can operate in confined environments.
This is no longer theoretical. A small robotic surgeon named “MIRA,” developed at the University of Nebraska, was recently sent to the International Space Station for testing. MIRA has two small arms equipped with graspers and scissors, designed to pass through tiny incisions.
In early 2024, astronauts tested MIRA by allowing it to cut and manipulate simulated tissue inside an experimental capsule. The long-term goal is to enable such a robot to perform emergency abdominal surgery on an astronaut, guided in real time by a surgeon on Earth.
One major challenge is communication delay. For a robot operating on Mars, signals traveling between Earth and Mars may take up to 20 minutes each way. This makes real-time remote surgery impractical. Engineers are therefore developing semi-autonomous systems capable of performing procedures independently after receiving high-level instructions.
What Will Health Professions Look Like in the Future?
The future healthcare professional may be a hybrid: clinician, astronaut, scientist, and engineer.
On Earth, a physician can refer a patient to specialists or call in a medical team. In space, the doctor may be the only provider available. Whether trained in internal medicine, surgery, or orthopedics, a space physician will require broad, multidisciplinary training. Within the same week, they may need to extract a tooth, set a fracture, suture a wound, and manage a chronic medical condition.
Many future space physicians may hold dual backgrounds — for example, emergency doctors with doctoral degrees in engineering, or surgeons who are also trained pilots. Flight experience may become a formal requirement before being cleared for astronaut duty.
Some institutions already offer programs in aerospace and space medicine. Centers such as Baylor College of Medicine’s Space Medicine program and the University of Texas medical programs provide training that covers everything from zero-gravity physiology to hands-on practice in simulated environments.
References
“How the Body Changes in Space” – Baylor College of Medicine: A concise overview of changes in muscles, bones, and body fluids in microgravity, where the human body becomes an open scientific experiment.
“Health Care in Orbit” – National Aeronautics and Space Administration (NASA): How astronauts maintain their health through strict exercise routines and continuous medical preparedness far from Earth.
“Surgery in Microgravity” – Space Shuttle Mission STS-90 Study (2005): An important experiment demonstrating that surgical procedures are possible in a space environment.
“Microsurgery in Orbit” – Journal of Reconstructive Microsurgery (2005): Research showing that surgical precision can adapt to conditions of weightlessness.
“Robotic Surgeon Tested on the International Space Station” – Space News: An early trial of a surgical robot operating in orbit, paving the way for remote procedures.
“MIRA Surgical Technology” – Virtual Incision: A miniaturized surgical robot tested in space to expand the boundaries of the operating room.
“The Rise of Space Medicine” – Association of American Medical Colleges (AAMC): An emerging field redefining medical innovation between Earth and space.
“COSMOS Training Program” – University of Texas: An initiative preparing a new generation of emergency physicians to manage medical challenges beyond Earth’s atmosphere.