Medicine has passed through many paradigm shifts, starting from the first establishments of hospitals and medical centers in the 1800s to the human genome project in the early 2000s. Such events changed our perspective on how we study diseases. They had substantial influence son societies worldwide. Changes root deeper than one can notice. They tackle our deepest core values and principles, especially when discussing bioethical beliefs such as genetically modifying children or still-controversial gamete donation programs. Emerging techniques, such as gene editing, make the practice of medicine more complex. This is why we should emphasize the need of a social and psychological leap that could reconnect society as a whole to the advancement in medicine in the near future.
Improving patient-doctor relationships is key to a better understanding of disease, patients’ wants and ethical matters. Focusing on the social and psychological aspect of diseases and how they affect patients is the next step in the advancement of medicine.
The Depersonalization of Medicine
Medicine does not wait for society. Rapid technological development in the field of molecular genetics has de-humanized the patients of today and of the near future. Diseases have transformed from a subjective personal experience into an objective set of symptoms and test results that may be treated with drugs. New techniques such as PCR (polymerase chain reaction), ELISA (enzyme-linked immunosorbent assay) and others made doctors, often unknowingly, shift away from detailed patient histories to focusing more on lab results, numbers and charts.
In addition, individualization of medicine at the molecular level is now available at several hospitals. Each patient can screen his or her whole genome for a relatively cheap cost. The patient turns into a file, a number and a dot on the normally-distributed graph of human information. The relevance of a patient’s work, personal life, preferences, thoughts about treatment and pain and other important aspects often goes unnoticed.
This depersonalization of medicine pushed medical schools worldwide to re-emphasize the importance of the patient as a human, not as a numerical puzzle to be solved. Each and every one of the patients is unique. Patients have their own names, not ID numbers. They have individual backgrounds, social factors, psychology and lifestyle. Understanding all these factors makes the diagnostic process easier and more specific. Also, the patient-doctor relationship improves, making patients more compliant and relieved.
Doctors do ask some questions that are meant to understand the patient’s social factors: “Do you smoke?” and “How often do you drink?” However, are such questions enough to learn about patients’ thoughts about their own diseases, how much they would sacrifice for treatment and what is most important to them in the long-term?
House, M.D. and the Future of Medicine
One answer comes from the famous show, House, M.D. The main character, Dr. Gregory House, and his team of doctors study specific cases that other physicians were unable to diagnose. Of course, correctly diagnosing the patients is a result of Dr. House’s sharp intelligence, or so he thinks. More importantly, however, the show emphasizes that knowing your patient’s social history and psychosocial background is sometimes essential to reach a correct diagnosis and treatment plan.
Although Dr. House has little direct contact with his patients, his team searches the houses of most patients. They look into patients’ workplaces, cars and other belongings, if necessary, looking for any information that might be helpful.
The team discovers related environmental factors and even genetic factors through these tours. Fungi, possible bacterial sources or a specific event in a patient’s yearbook may provide clues to a patient’s present condition and help with diagnosis. Throughout the episode, and throughout the doctors’ investigations, the viewer learns about the patient’s case medically, socially and psychologically.
House, M.D. may hold the key to future medical practice. Personalization of medicine on the social and psychological level is important to understanding the patient’s disease and choice of treatment. Furthermore, this approach guides diagnoses and may improve efficiency and accuracy. As the medical community absorbs technological advancements and applies them to patients, we find day after day that these advancements are still deficient if the patient is seen as a list of numbers and lab results. Once we know that patients are much more than a mathematical puzzle to be solved, and that illness is socially, psychologically and biologically intertwined, we will have truly taken the next step in medical advancement.
Contributing Writer
American University of Beirut
Medical student at the American University of Beirut, Lebanon. Other than medicine, my interests include philosophy, medical ethics, research, and journalism.