As a first year medical student, I feel as if my peers and I will be among the first to define a new generation in medicine. Many would argue (and have argued) that there will be no drastic change – no medical revolution, and that the above statement is simply a hyperbole garnered from my na ve idealism.
Change often happens relatively slowly in the medical realm, as the institution is well established and has no shortage of bureaucracy surrounding it. Personally, I think the days of gradual change have ended. The way I practice medicine will be significantly different than those that have followed this path before me. I assert that the role of physicians and the healthcare system will shift considerably.
As I was sitting in my biochemistry lecture a few weeks ago, listening to the lecturer talk in excruciating depth about fat metabolism and the “wonder drugs” that were developed to “cure” obesity (obviously none have had any significant success), I realized for the first time that my peers and I will be forced to become a different breed of doctor. Before I explain, allow me to throw out some statistics:
“Currently, more than 64% of US adults are either overweight or obese, according to results from the 1999-2000 National Health and Nutrition Examination Survey (NHANES). This figure represents a 14% increase in the prevalence rate from NHANES III (1988-94) and a 36% increase from NHANES II (1976 -80)” (The Obesity Society).
1900: M: 46 F: 48
1955: M: ~66 F: ~72
2010: M: 75 F: 80
Why was our society able to increase life expectancy by 22-24 years during 1900-1955, but only 8-9 years during 1955-2010? We now have more researchers, more communication, more technology, and more education. It seems illogical that we wouldn’t have a similar life expectancy increase. The increase during the first part of the 20th century was due to a myriad of advances, not a single great discovery (somewhat surprisingly the development of techniques for mass producing penicillin and its derivatives did not produce a life expectancy spike).
I propose that we are now dealing primarily with different subset of disease, and therefore need new and innovative cures. New drugs and new medical devices need to continue to be developed, but in order to ameliorate the society’s biggest health threats, doctors are switching to prevention and education. Prevention is a buzz word that has been thrown around by politicians, medical personnel, and patients.
In the future, primary care doctors may not reach for the script pad, they may instead treat with education. No amount of statin drugs can cure atherosclerosis and associated heart disease, no amount of insulin and anti-diabetic medication can cure diabetes, and no matter how advanced our cancer treatments get, these treatments will fail if the cancer is not caught early. Up until this point, health has been viewed as something that the medical field manages and imparts on individuals.
Over the next decade or so, I foresee individuals taking ownership over their health. In order to put health back in the hands of the individual, physicians, nurses, and other caretakers must impart the necessary knowledge and provide access the preventative tools that can ameliorate these chronic diseases that plague our society, and are among the top causes of death for Americans.
Tune in to my future blogs and follow me on my journey as I slowly discover what the practice of medicine is all about. I will continue to explore how I feel medicine will change as my peers and I enter the field, as well as current medical issues that I am confronted with.
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