The history of medicine is as old as humanity itself. However, it was not until perhaps the 18th century BC that the practice of medicine became codified, and the Hippocratic Oath arrived by the 5th century BC. Since then scientific and technological advances have improved our understanding of not just what causes disease, but also greater insight into how the aging process works and our hereditary pre-disposition to illness.
In our General Practice we focus on two aspects of healthcare – diagnosing and treating those who are unwell, and preventing illness in the first place. In terms of diagnoses and treatment we are fortunate that we have ready access to the latest advances in imaging diagnostics and blood testing to enable swift identification of issues. Urgent blood test results are available within two hours and reported diagnostics within 12 to 24 hours. This ability is a great enabler in quickly identifying and diagnosing health issues. A patient who sees the practice in the morning can potentially have answers to blood tests and imaging diagnostics by the afternoon, bringing not just answers but peace of mind to the patient and a care plan quickly.
It is in the second area, that of preventative medicine, that we are perhaps seeing more direct changes from technology and science. The use of wearables is increasing, including devices which record personal health data including heart rate, blood pressure and exercise. The options now are extensive, from devices which are more fun or information-based to estimate activity and record a few metrics, to more complex items which collect complex information. These feed into apps which enable greater capture of information about a person’s health and fitness, including how they feel, any symptoms they have, how their mood is and their cognitive functions. This all helps build up a picture of a person’s health over time.
As doctors we are able to access this information, with the patient’s consent, to monitor and understand a patient’s wellbeing. This can include setting alerts if a patient’s metric exceeds certain thresholds, or reminders to take medication or exercise. Instead of having to attend the clinic a person’s health can be monitored in almost real time by clinicians improving health management and providing greater flexibility for the patient.
Technology also gives the patient more control over their own health, setting parameters to live within and knowledge when to ask for help. Information and trends also motivate patients to improve health, providing them with targets to aim for and goals to achieve. The direct feedback gives them a reinforcing mechanism, which rewards positive actions. Using virtual healthcare records, patients can also become the custodian of their own medical records, taking them securely from doctor to specialist, from clinic to hospital and from one country to another.
This technology means that patients are much more mobile, being able to report on their condition from wherever they are in the world, speaking to their Doctor through secure video consultation when needed and feeding back their health data on a daily basis.
The new horizon in healthcare is around prevention and reversal. Conventional medicine revolved around curing ailments, one at a time, as they occurred. Care which was delivered in an episodic manner in response to patients requested treatment. This was good at dealing with the immediate issues, but tends to be poor to the long run as it can avoid underlying issues and is open to problems recurring.
Today more emphasis is placed on preventative medicine and wellness. The idea of discussing with people who are currently fit and healthy how their life style and health choices may impact their wellbeing in the future. A move away from reacting
to individual illnesses towards preventing multiple ones. The concept of the doctor working with patients to achieve and maintain an overall healthy body so that future illnesses and diseases are avoided or minimised.
This includes the use of genetic testing, with the potential to uncover a person’s predisposition to particular illnesses or how their lifestyle has affected their health, even when it is not immediately apparent externally. Care does need to be taken that only appropriate tests, be they genetic, blood tests or imaging diagnostics, are undertaken to ensure that the patient is not ‘overtested’ and that any results which are obtained have real meaning and can be acted upon.
Stem cell treatments are also becoming more established with a variety
of potential uses from delaying the need for joint replacements to more dramatic claims including being able to reverse the aging process or being able to teach cells. Still in its infancy, stem cell treatment is probably one of the most exciting areas under development at the moment. We are likely to see a great deal of work and development in this area over the next few years.
