No sooner had the ink dried on my post, Telemedicine: The Medicine of the Future, than some blogger pronounced telemedicine the “medicine of the past.” There, by a stroke of the pen, someone purported to nullify my prescient writing on healthcare law and relegate to, as Ronald Reagan used to say about communism, the ash-heap of history.
Don Miguel Ruiz says in his book, The Four Agreements … many wise things, but the one that sticks is, “don’t take it personally.”
The real point is that whatever future healthcare may be, there is now a sea of terminology, none of which may stick. We have telehealth and telemedicine, or some call it online healthcare or e-health; then there is m health also known as mobile healthcare; we have mobile medical apps; and recently, at a conference of medical and healthcare app ventures, I heard of the “re-imagination of healthcare” via entrepreneurial startups. And let’s not forget, concierge medicine.
In my work on laws governing complementary, alternative, and integrative medicine, I always thought of integrative healthcare as a stepping stone toward a vast synthesis of the best of technological, “Western” medicine, also known as biomedicine or conventional medicine (a politically laden term), with Eastern healing traditions, also known as part of CAM (complementary and alternative). Then there is energy medicine, and I wrote a book called Future Medicine which was essentially about the revolutionary leap from the physical, to what some might call, fifth dimensional or even vibrational medicine. (Quiz: what is the connection between homeopathy and Interstellar?)
During my days on faculty at Harvard Medical School, I remember one speaker in our alternative medicine CME course, Ralph Snyderman, Dean at Duke Medical School.
That such a high-level dean would speak on integrative medicine was somewhat of a coup, given the battlefield in those days; even more electrifying, though was Dean Snyderman’s way of integrating what we already thought of as integrative medicine, with a vision of the future based on genomic medicine, which he called personalized medicine or personalized healthcare (PHC).
In Personalized Medicine 2014: has healthcare been transformed?, Dean Snyderman writes about the transformation of healthcare in a decade of personalized medicine. He views scientific medicine as the triumph of the sciences over mysticism, and DNA sequencing as a quantum jump. He sees the first wave of science as pathology, chemistry, physics and microbiology; and the new wave as proteomics, metabolomics, bioinformatics, all of which provide “a new medical capability: prediction – the ability to quantify disease risks and to detect disease development before damage occurred.”
Dean Snyderman also calls this “prospective medicine, a new proactive, personalized model of healthcare delivery.” This involves the “interplay of genetics and environment over time,” such that we can quantify an individual’s disease risks, “deploy preventative measures and track progression or regression over time.”
Here, future medicine – whatever we call it – meet integrative medicine, meets wearable health tech and the quantified self. Much of complementary and alternative medicine is about prevention and healthy lifestyle – whether through nutrition, exercise, manipulation of your spine or movement of chi; so if we can predict through genomics, prevent through CAM, and track through wearable health tech, we have entered a new healthcare age.
Dean Snyderman talks about SNPs and the impact of genomics on oncology, with the identification of genetic mutations predicting susceptibility to breast and ovarian cancer. “Within a decade,” he says, “I expect that a major focus in healthcare will be on enhancing health, longevity and minimizing disease as well as personalized care for established diseases.”
All this is, of course, patient-centered medicine, as it puts the individual at the heart of care. Which is what the best of technological medicine and holistic health care are all about.
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