Individualized Medicine

It wasn’t too long ago that clothing and shoes were made by tailors and cobblers who were skilled in customizing their products for the customers they served. The industrial revolution almost put an end to that approach, as products made by machines caught the eye and pocketbooks of consumers everywhere and tailors and cobblers all but slipped into the shadows of the past.

The trouble was that mass production resulted in a product that didn’t fit as well. Clothes and shoes were made in stock sizes and were designed to fit the “average person,” whoever that is. Moreover, it made shopping for clothes and shoes a less personal, less personalized and more challenging experience.

Strangely enough, healthcare went through a strikingly similar evolution. Pre-industrial medicine was patient-centered, individualized. The doctor met with the patient, took time to get to know the peculiarities of his illness experience and then compounded a remedy specifically for him.

Nowadays medicines are made to address a patient’s disease, more or less without respect for the patient’s illness experience. Population-based clinical trials shape new medicines, rather than specific individual needs and the resulting products, like the clothes and shoes we now wear, don’t really “fit” the patient’s needs as well as a custom-tailored prescription would.

Bespoke clothes and shoes generally cost a fortune and are typically reserved unto the 1%. That said, Nike and Levi have started selling custom-tailored shoes and pants, albeit using computers and machines programmed to approximate the artistry of the old-world tailor or cobbler, to the less wealthy. I suppose that scientific advances in mapping the human genome, collecting and processing medical data and so on will eventually result in custom-manufactured pharmaceutical drugs, but for now bespoke medicine is delivered primarily by naturopaths, chiropractors, acupuncturists, homeopaths and other “alternative” health care practitioners.

You may not be able to afford a bespoke suit from Kiton or a custom-made pair of shoes from John Lobb, but you can get a jump on what is likely to become the future of medicine by making an appointment with an integrative medical doctor or nurse practitioner or an alternative health care practitioner the next time you’re not feeling well.

If you can buy a pair of pants or shoes that are made from scratch using materials that not only fit you perfectly, but accentuate your assets, doesn’t it make sense to try and care for the inside of your body the same way? Individualized medicine is the wave of the future.

9 thoughts on “Individualized Medicine

  1. Zach

    You hit the nail on the head. Instead of providing a customized approach, medicines are thrown at the symptoms until they recede, with little thought as to what initially caused them. The customized solution will always be better than the “one size fits all”.

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  2. Coco

    I’m not in the health field but as a consumer I appreciate most when the doctor is looking for long term changes. It seems my family doctor will usually try to alleviate my symptoms, while my acupuncturist tends to use them as information. I have had some painful symptoms subside with acupuncture, but even better, I’ve had illness cease altogether…hopefully forever. Another difference is my family physician never requires many life style or food changes but my acupuncturist is all about that. So perhaps the consumer needs to be ready to make changes as well.

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  3. CW

    Gregg,
    I really enjoyed your post this morning and have been reading a lot lately and trends in Health Care. One of the criticisms in the allopathic world is that doctors “Treat to the Mean”. A patient comes into the hospital or a doctors office and is diagnosed with a condition and they are prescribed a treatment that is supposedly best for the average person with that condition. Often this is a prescription drug that might alleviate the symptom for most people with that condition. This ignores that fact that the cause of these conditions can vary and therefore the treatment needed should vary as well. One trend on the horizon is using predictive analytics in medicine. For this to take place, a health care system would need to bring together all of the different forms of data that exist on a patient such as Medical Records, lab results, radiology images and data from mobile medical devices. Through some analysis, you can profile and cluster on what outcomes would be best and begin to customize treatment. This wouldnt be the same as the individual one to one medicine but it seems a step in the right direction. Of course deciding what an optimal outcome would be critical as well. It could help identify a patient who is headed for a heart attack or a stroke before those events happen. It could also identify patient who are at high risk for an infection or a fall and improve their care so that these things are avoided. This could also apply to the alternative health fields. For instance, what if a practitioner had records on hundreds or thousands of patients and they used statistical analysis to identify what patients with similar factors had improvements in their health and well being. A program could suggest a course of treatment to the practitioner who could then evaluate if this suggestion made sense. This could be a helpful tool used in conjunction with treating someone but not something that would take the place of the sound judgment of a practitioner. There are some transformative trends taking place that if used wisely could positively impact the health of patients.

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  4. Strawberryfield

    I have the same experience buying shoes as I do getting a prescription. I have to keep trying them until it more or less works well enough. With shoes I just keep returning them. With medicine it has taken me up to four or five tries to get the one but with each sample I had to face a host of additional, at times very frightening side effects. I’ve had friends that it took a year of trying on prescriptions until one she could tolerate was found then the finding the right dosage was another year of poor health. This system doesn’t work and the days of having no other options are over. Great post, let’s get the word out!

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  5. Ricardo B.

    Well said…….as a naturopath myself, most people who seek my services typically do so after their numerous attempts through conventional medicine’s networks have not yielded the health and vitality that they aspire. They come back with stories that would break your heart if you heard them with pure sympathy. These are stories I hear daily, and that is no exaggeration.

    The hurried and frenzied pace of industrialized medicine, in conjunction with its sharp compartmentalized structures, gives no room to attend to the individual’s very specific needs. Rather, it forces the individual to fit in a pre-fashioned mold that superficially appears to be the closest ‘match’. The problem is that in medicine, things are not as they just appear, ie, symptoms do not define, cannot define, the unique condition. If you had 10 people in a room and they all had a headache, all of them hurting at the temples, they could all be manifesting from different causes. So, would you give them all the same medicine?

    There used to be a saying amongst the old-time doctors that “labwork is for doctors who don’t understand medicine.” Doctors far too often treat their patients strictly on what lab values and their standardized reference ranges tell them, even when their patients tell them they do not feel any better. It’s the system, the approach and the underlying philosophy that creates the errors, and it would be wrong to simply blame the doctor here.

    No one can stop a message whose time has come, no matter how much effort is thrown at it. Medicine, much like faith, taps in to our deepest roots and everybody, every individual, owns their own health by birth. Until a system comes along that honors this, I feel we will continue to compound the multiple troubles that we see today. Individualized medicine is the dawn of a brighter, more optimistic future, and I for one have dedicated my life to its construction.

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