Preventative care and personalized medicine will be powerful forces in the medical community in coming decades, said speakers at a bioethics conference this weekend.
The three-day 2011 National Undergraduate Bioethics Conference titled “Bioethics: More Personal or More Global?” drew students together to discuss ethical, social and legal implications of developments in technology and medicine. One Friday session opened with a video introduction from Duke Trustee Paul Farmer, founder of Partners in Health and Trinity ’82, in which he noted discrepancies in access to quality health care between the rich and the poor.
Two medical experts then took the stage for addresses to the conference’s attendees: Dr. Ralph Snyderman, chancellor emeritus of the Duke University Health System and James B. Duke professor of medicine, and David Ewing Duncan, awarding-winner author and journalist who recently published the book “Experimental Man.” Snyderman focused his speech on the transformation of health care into a more preventative and proactive practice versus a more reactionary approach he referred to as “find it, fix it.” Duncan detailed the experience of researching his book, which consisted of putting himself through countless genetic and environmental tests to determine his predispositions to numerous medical conditions.
“We are in the beginning of what I consider to be the second biggest transformation of medicine,” noted Synderman, citing new health care reform and increasingly advanced medical technology. The other major transformation was in the 20th century when doctors developed a more scientific understanding of disease and its causes.
Synderman said medicine should be more focused on prevention of health threats instead of simply treating current diseases and conditions. He noted that two-thirds to three-quarters of hospital money is spent treating diseases that could have been prevented before they developed.
This sort of care would be less lucrative for hospitals but necessary in the future to accommodate the growing number of people needing doctors and medical advice.
“Personalized medicine [will be] an approach to health care that recognizes each individual’s unique health risks, strengths and needs,” Synderman said.
Synderman said he expects the “find it, fix it” method to be something of the past as soon as a decade from now, and noted that people will increasingly go to doctors for preventative care.
Duncan then took the stage and focused his remarks on the methods of personalized medicine. To research the value of genetic testing for “Experimental Man,” he said he underwent labs from more than 250 companies, donated 3 liters of blood and was tested for 7 to 10 million genetic markers.
By comparing his results to national data, he was able to evaluate his susceptibility to certain diseases. For example, Duncan noted that his percent chance of having a brain aneurism is 15 percent greater than the average expected for his reference group.
Although Duncan admitted he was slightly skeptical of some of the results, he noted that these tests could soon be widely available, especially if the costs of genetic testing continue to decrease. Currently, however, they are not entirely cost-effective.
If people know about their own predispositions to certain diseases, he said, they may be more likely to alter their lifestyles to decrease their risks.
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