>Personal Medicine – towards efficient medicine

>I’ve posted a couple of thoughts on Personal Medicine, lately. They’ve been fairly popular, and obviously controversial enough that people have taken the time to comment. (I really appreciate that, by the way!) Those comments are very useful in giving me an opportunity to think about the subject in ways I hadn’t considered. (Thanks, again, to those who chimed in on the last two posts!) So, I have at least two more topics I want to cover. The first one is “efficient medicine.”

All this talk about personal medicine is interesting, because it’s relatively obvious what everyone means: using a patient’s genomic/transcriptomic information to make personal health decisions that are tailored to suit the patient’s personal needs. Hence, it’s personal medicine. However, the question really has to be asked why we’re doing it. I contend that the personal medicine is a technique, but the underlying goal is really “efficient medicine.”

By efficient medicine, I really mean efficiency in several ways:

  1. More efficient use of medication (1): treating only those people who will benefit from the treatment.
  2. More efficient use of time: automate health care so that we can figure out the right treatment more quickly.
  3. More efficient use of resources: treat people once with the right medication, so that less time needs to be spent in clinics and hospitals
  4. More efficient use of medication (2): ensure people treated with medications won’t suffer from adverse effects, which has a human cost as well.
  5. More efficient use of doctors: Allow doctors to spend less time trying to diagnose problems, and more time trying to figure out how to solve them.

I’m sure I could go on, but by now everyone gets the idea. Efficiency means something different to everyone in the medical chain of command, yet I’d like to think everyone is striving to provide more efficient medical care. Whether the medical funding agency wants to save money by not treating non-responders to a drug, a hospital wants to save resources by pro-actively treating an out-patient (metabolic disease), or whether the doctor wants to spend less time trying to figure out the root cause of a patient’s problem (eg. Crone’s disease), knowing what’s going on at the genomic level will make the medical care more efficient for everyone involved.

So, let me re-iterate my other points from the past few blog items: We are near the tipping point where the cost of personal medicine is becoming sufficiently low that the efficiency benefits from taking advantage of it will have a measurable effect.

Once that takes place, it will be a tide that washes away the in-efficient medical practices of the past. Medical funding agencies won’t fund doctors or medical practices that waste time or money, and that will force through changes that make personal medicine the only way to do business.

Again, I’m not arguing that doctors are incompetent, just that personal medicine will change the baseline level of efficiency we demand, and that MDs will need to cope with that change.

And, as a corrolory, that’s going to lead to an aweful lot of medical funding agencies to start funding lifestyle changes. (Go to the gym 3 times a week, and save 50% on your insurance….) Change is coming, people… and you don’t need to be an MD or a PhD to see it.

And speaking of efficiency, I have a few more things I need to get done this afternoon! Back to the grindstone…

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