People forget that physicians are patients, too. We get sick. We need treatment. We visit our fellow doctors.
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In fact, physicians often are the worst patients. We don’t make time for our health needs — as I failed to do while suffering from sinus congestion and pain for several weeks recently. We think we already know what is wrong with us, so we diagnose ourselves.
Having too much information can be scary, though. As a physician-patient, I find myself remembering the worst-case scenarios I have seen in the hospital in terms of adverse reactions to drugs — Clostridium difficile colitis (a bacterial infection in the colon caused by antibiotics), Stevens-Johnson syndrome (a disorder induced by medications that affects skin and mucous membranes) and anaphylactic shock, to name a few. Adverse drug events are a leading cause of hospitalization in the United States.
When my own sinus symptoms got bad enough, I finally broke down and saw my doctor. I received a prescription for amoxicillin, a standard antibiotic at a very standard dose, given to many patients for various types of infections.
Before I took the first pill, I found myself wondering if I would have some sort of terrible drug reaction. I am much smaller than the average 70 kg (about 154 lbs) male, and my ethnic origin is different than many other Americans. Would this pill, which usually works for the “average person,” work for me? Would this pill, which is usually tolerated by the “average person,” be tolerated well by me?
I got myself so worked up that I almost didn’t take the pill. And we wonder why our patients don’t always comply with our recommendations. Taking medications in today’s healthcare environment requires a leap of faith.
What comes next?
When will healthcare move from trial-and-error to true evidence-based and personalized care? I envision a future in which I can better predict and prevent diseases for every patient individually. I envision a closer relationship between physicians, patients and the rest of their care teams. I envision a future in which I can recommend a medication for a patient with increased confidence that it is the right therapy at the right dose for the individual patient in front of me — just as other doctors can do for me.
Will we reach this goal for personalized healthcare in 5–10 years? Probably not, but I believe we will be closer. We will be using electronic health records in integrated, efficient ways to help doctors and their patient partners make better decisions. We will see increasing use of genetic markers for drug metabolism and other biomarkers to better select therapies for individual patients. We will have models of care that prevent complications of chronic diseases. And we will see improvements in payment for these models of care, efficiencies and personalized healthcare approaches.
If we are successful in integrating personalized healthcare in a cost-effective and efficient manner, I believe we will achieve our ultimate goal — healthcare built around you (and me).