The revolution (in medicine) will not be televised

Bob Messerschmidt bobm@me.com

Abstract

There is a coming revolution in medicine!  Perhaps you have heard about it?  It's all over the news.  In reality, ’revolution' might be the wrong word for what’s coming.  Maybe something more like 'systematic improvement through technical advancements, clinical validation, and data-driven diagnosis.’  But that does not flow off the tongue quite as easily. 

It’s wrong to think of this as a revolution for several reasons.  For one thing, medicine is a slow moving beast, and revolutions are fast.  We should not expect fast changes.  For another, the romantic idea of a revolution must have a bad guy, an old regime, an antagonist just holding things back.  But here there is no villain.  For the most part our field is filled with good intentions. 

There are certainly many important changes afoot.  History will show that one of the most important changes is the drive toward actionable data-driven medicine.  The need is undeniable.  In the future, your health care provider will be less well trained, younger, less experienced.  She will be less likely to have the wisdom of the ages, that ability to diagnose you and treat you, almost instinctively.  This model no longer works, if it ever did.  Intuition is great, except when it isn't.  Health care consumers will no longer accept a system where life itself  can depend on whether you had access to a top doctor.

In the future, there will be no magazine issues with glossy photos proclaiming your city's "top doctors."  There will be no need.  In the future, everybody will have access to a data-driven diagnosis and treatment plan, because the data will speak the truth.

And where will this data come from?  From you of course.  Mostly from your molecules.  Sometimes from your DNA, but most importantly from your blood.  Blood has always been the gold standard for diagnosis, and that will not change.  But the answers will become more immediate, more complete, and more actionable.  Answers will need to arrive at the point of care, right along with vital signs and equally fast.  The price for these answers will be a simple finger stick followed by rapid spectroscopic chemical analysis.

This talk will focus on these important questions:

  • How will this approach effect patient-centered care
  • Where will be the “medical home”
  • Data considerations - who owns it?  Privacy?
  • What are the risks of wrong answers?

Rapid point of care blood-based testing will change the heart of medicine from hard-earned expertise to data-driven automation, and this will happen because this approach is scalable to benefit everyone.  Who knows, we might even look back some day and say that this was a revolution waiting to happen.

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