How good is the healthcare system? How well do physicians treat their patients?
For doctors and physicians down the centuries, since the times of the Greek, the Hippocratic Oath was a great guiding force — stating that they have to adhere to certain ethical standards. And the tradition continues even today, even though, as we shall see it’s not that idealistic today as it was before.
The Hippocratic Oath mentioned does no harm- but as physicians, it could be difficult to do justice to it all. The philosophy of Hippocratic medicine doesn’t seem relevant in the face of modern medicine, which concentrates on specific diagnosis and specialized treatment promoted by the Knidian School. This thought is mainly responsible for the population-based medicine practiced today, a reason the Hippocratic treatment has been criticized for many years, after this crucial shift in medical care.
Yet, while nearly forgotten, there are some questions that we do need to answer first.
The Good and Bad of Population-Based Medicine and Personalized Medicine
Population — based medicine is one of the most common approaches in practice. According to The American Medical Association, it is an approach to assess the health requirements of a chosen population in a bid to improve them through interventions and effective care keeping considerations such as health resources, culture and policies of the population in mind.
The approach focuses on the health of an entire population and not that of an individual. It is a cost effective method to provide immediate care to the target population to improve the health outcomes. But it completely ignores the individual needs of the patients and doesn’t include those in the society who are not under the majority. The concept evades the needs of the minority individuals and population who would have benefitted from a treatment considered ineffective by population model. It can also prevent the patients in the majority from getting improved treatment as the model doesn’t support it.
Before going into personalized medicine, let’s talk about two different concepts:
· Personal: Something intended for a specific individual keeping his needs and preferences in mind.
· Personalization: Refining or tailoring a service or product to meet personal needs
So personalized medicine identifies patients groups and tailors the medical products, interventions, decisions and treatments based on the group’s risk of disease or predicted response. You can find terms like precision medicine, P4 medicine and precision medicine to refer to personalized medicine and they don’t have many differences if not otherwise implicated by the users.
The roots of personalized medicines can be traced to Hippocrates. But the term has gained momentum in recent times with diagnostic and informatics technologies making it possible to go down to the molecular basis of a disease. This understanding of genomics makes it possible to identify individual needs and provide effective treatment.
Why is Population-Based Medicine not Suitable?
The population model is not sensitive to a patient’s individual needs in its basic level. Individual needs are set to increase and become important in this age of technology and an educated society. Patients know what is best for them and aren’t ready to compromise on any grounds.
Population-based medicine works for a society where expectations are low and the government needs to resolve health issues of a chosen demographic with minimum investment. But that isn’t the case with the current social and wireless generation- we can see how developed countries around the world are not being able to match what they want, what they need and what ultimately is given to the people.
We need Population-Based Medicine with a Personal Touch!
We need the population-based model for its cost effective approach of narrowing down specific risks and its potential to benefit medical data in healthcare delivery. We then need to implement the personalization component to improve the treatment model ensuring quality health care for every citizen of the country. It will also help in customizing treatment options for the individual and not for the majority of a society.
We have the knowledge and technology in the present time to achieve personalization of population-based medicine. This especially holds true for developed and developing countries who can implement this effective model.
The Role of AI in Personalization
AI or Artificial Intelligence has now become a part of our life as we ask Siri to set the alarm or talk with a chatbot instead of a human representative. Computer systems are exceedingly carrying out tasks requiring human intelligence like speech recognition, visual perception, language translation and decision-making and can soon reach perfection.
The technology can be used effectively for artificial diagnosis but it is not going to remove human intervention as many wrongly believe. AI depends on human contribution to facilitate its machine learning and deep learning so we would always need human expertise. With help of AI and human expertise we can broaden the scope of artificial diagnostic field making inclusion criteria much more specific and narrower while making exclusion criteria easier. We can effectively create a diagnostic workshop with help of AI and its capability to centralize data from multiple sources.
Can we Reach There?
We have the technologies, strategies and resources to create the suitable environment by promoting active participation, design and interoperability of all stakeholders in healthcare. Individual empowerment, a sense of responsibility and independent thinking will help us traverse the path in our journey of personalized healthcare.
We need to utilize the low cost delivery model and reasonably effective plan of population-based medicine and combine it with personalized medicine to tailor it to personal needs and indications. AI can help along the way helping in diagnosis and reducing errors that result from human intervention. The learning acquired by AI is passed down the generations through blockchain technology transferring the human learning along the chain of human existence.
Would Hippocrates have disagreed with this personalized model of medicine adapted for the new era?