Sunday, January 26, 2020

Personalized Medicine - The Future of Medicine

Future doctors will celebrate that they no longer prescribe the same drug at the same dosage for hypertension or pneumonia or arthritis or cancer or many other conditions.  Who knows even if drugs will be the mainstay of medical treatment.  Tomorrow’s treatments will be tailored to one’s age, gender, weight, race, overall medical condition, severity of the medical threat and genetic profile, among other variables.  We don't all wear the same sizes of socks and shoes, but yet medicine today has a one-size-fits-all treatment utility.  A new era, however, is upon us.

What will be the fate of my beloved colonoscopies or heart catheterizations or blood draws or biopsies of tissues?   Fear not.  They will all be available to you, just as Van Gogh paintings or fossils of T-Rex are -  in museums.  The first exhibit will be a diorama of the physician’s office from yesteryear, adorned with some antique artifacts such as a stethoscope, an EKG machine and a reflex hammer. 

Museum Quality

Without question, health care will smash through one barrier after another.  But, the humanity of the profession will be subsumed and sacrificed as the medical technological tsunami bursts forth.  Our health will improve but the health care experience will be unrecognizable.  Indeed, all aspects of our lives will be technologically driven.  Today, Alexa can turn off the lights.  Tomorrow, Dr. Alexa might be cleaning out our arteries. 

And while technology will permit portions of the exam to be transmitted, such as vital signs, heart and lung sounds, skin lesions, etc., I don’t see how a patient’s abdomen can be palpated, at least not yet.

Performing robotic surgery remotely is already a reality and such surgeries and medical procedures from afar may become commonplace.  Individuals may place their smart phones on various parts of their body and transmit information to their physicians.  Patients may be able to use their phones or some other device to do a CAT scan (or whatever technology will replace it) on their own bodies.  And, reminiscent of the once futuristic novel Fantastic Voyage, patients may swallow a trackable pill that can course throughout the body transmitting data about the health of various tissues and organ systems.  Similarly, medications will be customized to each individual that can be directed to the target location.  For example, a medicine for Alzheimer’s disease will be personalized for a specific patient with the drug remaining only in the brain.  These developments will boost drugs' efficacy and reduce adverse drug reactions.   When drugs are free to roam throughout the entire body, obviously there will be unintended and unfavorable consequences.

The routine physical examination may be replaced by spitting into a tube or submitting a cheek scraping for a comprehensive medical analysis.

We can hope and pray that the upcoming technological take over will be guided and restrained when necessary by just and ethical principles.  The revolution is coming and no force can derail it.

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