Posts Tagged ‘medicine’

The Heroism of Incremental Care

Sunday, February 19th, 2017

The Heroism of Incremental Care, by @Atul_Gawande Positively compares GPs-v-surgeons to bridge inspectors v rescuers

“For a long time, this would have seemed as foolish as giving your money to a palmist. What will happen to a bridge—or to your body—fifty years from now? We had no more than a vague idea. But the
investigation of the 1967 Silver Bridge collapse marked an advance in our ability to shift from reacting to bridge catastrophes to anticipating and averting them.

Around the same time, something similar was happening in medicine. Scientists were discovering the long-term health significance of high blood pressure, diabetes, and other conditions. We’d begun collecting the data, developing the computational capacity to decode the patterns, and discovering the treatments that could change them. Seemingly random events were becoming open to prediction and alteration. Our frame of medical consideration could widen to encompass our entire life spans.

Our ability to use information to understand and reshape the future is accelerating in multiple ways. We have at least four kinds of information that matter to your health and well-being over time: information about the state of your internal systems (from your imaging and lab-test results, your genome sequencing); the state of your living conditions (your housing, community, economic, and environmental circumstances); the state of the care you receive (what your practitioners have done and how well they did it, what
medications and other treatments they have provided); and the state of your behaviors (your patterns of sleep, exercise, stress, eating, sexual activity, adherence to treatments). The potential of this information is so enormous it is almost scary.

Instead of once-a-year checkups, in which people are like bridges undergoing annual inspection, we will increasingly be able to use smartphones and wearables to continuously monitor our heart rhythm, breathing, sleep, and activity, registering signs of illness as well as the effectiveness and the side effects of treatments. Engineers have proposed bathtub scanners that could track your internal organs for minute changes over time. We can decode our entire genome for less than the cost of an iPad and, increasingly, tune our care to the exact makeup we were born with.

Our health-care system is not designed for this future—or, indeed, for this present. We built it at a time when such capabilities were virtually nonexistent. When illness was experienced as a random catastrophe, and medical discoveries focussed on rescue, insurance for unanticipated, episodic needs was what we needed. Hospitals and heroic interventions got the large investments; incrementalists were scanted. After all, in the nineteen-fifties and sixties, they had little to offer that made a major difference in people’s lives. But the more capacity we develop to monitor the body and the brain for signs of future breakdown and to correct course along the way—to deliver “precision medicine,” as the lingo goes—the greater the difference health care can make in people’s lives, as well as in reducing future costs.”

Medicine’s Burning Question – The New Yorker

Monday, January 25th, 2016

Inflamed by @Groopman #Medicine’s Burning Q: Is inflammation the root of all problems or just a correlate to them?

One big myth about medicine: We know how drugs work

Saturday, August 8th, 2015

Big myth about medicine: We know how #drugs work “If you only half-know something, you can appreciate serendipity”

If you think you’re too smart and you only do what is scientifically indicated, there’s always going to be something, ‘Oh my God, we never thought of that!’” Haber said. “If you half-know what you’re doing, then you’re better prepared to understand or appreciate discoveries that are serendipitous in some way.”

A 2011 study reviewed a decade worth of drug approvals found that of 75 drugs that worked in a completely new way, 28 came from the more old-fashioned method of screening drugs against cells or animals, and 17 were built from detailed understanding of how the disease worked. David Swinney of the Institute for Rare and Neglected Diseases Drug Discovery said that despite the fact that far more resources are devoted to developing drugs by focusing on targets, the older method of screening has been more productive by his analysis.”

How 3-D Printing Is Changing Medicine

Monday, December 8th, 2014

How 3D Printing Is Changing Medicine Common in orthodontics (@Invisalign) & some surgeries. Printable organs next?

Also, 3D printing is now available from Amazon & Staples, viz:

John Colapinto: A Surgeon Helps Singers Sing Again : The New Yorker

Saturday, June 15th, 2013

The elasticity of vocal cords, the difficulty of operating on them & the story of a surgeon doing this #medicine

Coaching a Surgeon: What Makes Top Performers Better? : The New Yorker

Saturday, October 13th, 2012

Annals of Medicine: The Colic Conundrum : The New Yorker

Saturday, January 14th, 2012