Future of Medicine: Can We Reach Atomic Level?

[Cod]

From my understanding, researchers around the globe are studying more and more into gene therapy and "smart molecules". As many of you all know, these could possibly end up curing numerous forums of cancer as well as many herditary diseases that kill many each year. This brings me to my question: With medicine currently on the molecular level, will we one day be on the atomic level? I ask this because I'm not sure of a few things: Is it possible for us to reach that level in medicine? And if we can reach that level, would it make things easier to solve diseases? Lastly, if we reach the atomic level, would we one day be able to cure a full-fledge virus?

I'm a newb when it comes to biology, so please bare with me . Any help is greatly appreciated.

 

[ryokan]

With medicine currently on the molecular level, will we one day be on the atomic level?

It isn't essential such difference in therapies between a molecular and an atomical level.
As treatments, physicians use both molecules or ionized form of atoms. For example, Ionized Lithium is an effective medicament for the treatment of bipolar disease. It has been used since the 50's. Ferrous ions are used to treat ferropenic anemia.

I don't know if you refer to the resolution level of basic research, for example, in microscopy. That would be another question.

 

[avant-garde]

In this case, could the job of many doctors become obsolete?

 

[Ygggdrasil]

Doctors will never be obsolete. People are not easy systems to work on. Every person is unique and the same problems will manifest themselves differently in different people. So, to correctly diagnose the problems facing people will require doctors. Of course, diagnostic tests are improving rapidly and could make the problem of diagnosis much easier. However, no treatment is perfect. Every treatment will have its pros, cons, and side effects. Especially in the case where the patient has multiple conditions that are interacting (common in elderly patients), you will still need a highly trained doctor to determine the correct treatment for the patient.

Finally, patients are people. and doctors play an important role in communicating important medical information to their patients and helping them with important medical decisions. This is a fundamentally important role for doctors that technology will not replace anytime soon.

 

[Nan]

Doctors will never be obsolete. People are not easy systems to work on. Every person is unique and the same problems will manifest themselves differently in different people. So, to correctly diagnose the problems facing people will require doctors. Of course, diagnostic tests are improving rapidly and could make the problem of diagnosis much easier. However, no treatment is perfect. Every treatment will have its pros, cons, and side effects. Especially in the case where the patient has multiple conditions that are interacting (common in elderly patients), you will still need a highly trained doctor to determine the correct treatment for the patient.

Finally, patients are people. and doctors play an important role in communicating important medical information to their patients and helping them with important medical decisions. This is a fundamentally important role for doctors that technology will not replace anytime soon.

Excellent response. To the OP, human physiology is vastly complex, includes molecular biology and organic chemistry. The human genome project was productive in mapping genes, it is a watershed in discovery which undoubtedly will lead to therapies for very vexing diseases, if not out and out cures.

Its unfortunate that today, doctors and nurses have little time for instruction/education of patients. Once upon a time, nurses played an important role in education of patients and their caregivers. This has also unfortunately lead to preventable problems especially for chronic care disease states and even relatively simple discharge planning/education. There is currently a critical shortage of RNs and college educators; primary care physicians are in short supply, currently fewer and fewer MDs are electing to enter primary care and instead are entering specialty practices.

One place where physicians *might* be replaced is in the OR suite. Robotic surgery is currently being developed and isn't far away from common use. I suspect for 'routine' and non-life threatening surgery it will become very common; however, I can't imagine that robots will entirely replace highly skilled surgeons and nurses in this area.

 

[avant-garde]

Ok, maybe not all doctors will disappear, but certainly technology may make obsolete certain rotary functions?

For instance, many futurists predict that medicine will be focused more on prevention than cure in the future. If that's the case, prevention does not really require a human physician, but merely a highly accurate scan that will detect a problem before it happens. A machine will certainly be able to do that; it's likely that less people would go to doctors to get cured, and thus the demand for doctors would go down significantly.

Please please please correct me if I'm making any unreasonable assumptions. lol

 

[Nan]

Maybe not unreasonable but certainly very futuristic. Not all, not even close, to all diseases and conditions can be mitigated through preventative measures. More likely there will be DNA therapies or cures otherwise which will in the future be able to do that, but that is even still a very far way off. Nature is interesting too, once one problem is 'solved' yet another seems to crop up that is unexpected, sometimes by our own devices.

Technology will, as always, provide solutions; and, has been the case in the development of other technologies, there will be a darkside to it. This why there must be, imo, ethical guidelines which are forward looking to meet with the rapid changes in science and technology as it relates to care of people. In procreation it is possible to make predetermination's regarding a child and most certainly will expand beyond sex selection. Should that 'advantage' only be allowed to those who are wealthy enough to afford it or should it be extended to everyone?

Care of people will always require human interface for communication, assessments, for no other reason than to express care and concern, provide comfort and compassion when technology does fail to provide solutions. We will all die and we will all die of something.

The human condition is messy and will always be messy, technology can help but will never provide a substitute for what one human can do for another human. A human delivering even a painless vaccine to a child will soothe that child if they are frightened over even an extremely sophisticated android. A physician will speak with a patient and as they do so, they are evaluating more than mere recognition, thought processes and speech.

Just my 0.2 cents, fwiw.

 

[Moonbear]

I would also remind readers that medicine and "doctoring" involves more than just physiology, anatomy, biochemistry, etc. There is very much a personal, social side to medicine. Even if the diagnosis is the same, don't you think it's better to have news of a life-threatening illness presented by a person and not a computer? Someone who can act as the gatekeeper if you need other assistance in dealing with that illness...do you have someone who can be a caregiver at home, do you have a social support system in place, do you need assistance with making your home more accessible either on a short-term or long-term basis if your mobility will be impaired, etc.

Doctors and nurses are helping to treat the PERSON, not just the disease.

 

[avant-garde]

My question then, is why do you need a doctor (10+ years of schooling) to do that?

With the aid of technology, you could have a nurse fill in that role instead...when people realize that the practical importance of the doctor himself has diminished significantly, then maybe they wouldn't feel the need of personal interaction with the doctor so much?

As I see it, technology might be able to make doctors obsolete... but won't diminish the importance of nurses.

 

[Nan]

My question then, is why do you need a doctor (10+ years of schooling) to do that?

With the aid of technology, you could have a nurse fill in that role instead...when people realize that the practical importance of the doctor himself has diminished significantly, then maybe they wouldn't feel the need of personal interaction with the doctor so much?

As I see it, technology might be able to make doctors obsolete... but won't diminish the importance of nurses.

The reason is because of the complexities. We still do not fully understand how the brain functions, there are still mysteries associated with bio-chemical, hormonal, immune-system, DNA and other physiology. Couple that with mysteries that are yet to be answered in differing responses of people with the same physical makeup, same disease and same treatments. Human physiology is vastly complex.

Physicians are diagnosticians, believe it or not, some diseases are still being discovered and classified. They can provide therapy for people who may not fall neatly into a diagnostic criteria but are suffering. They are detectives and follow clues, they are parent-like in making recommendations to adults in living healthy life-styles and can assist them in accomplishing that.

So while there may come a time when technology is able to reduce the number of needed clinicians it is still a very, very far way off.

 

[Moonbear]

My question then, is why do you need a doctor (10+ years of schooling) to do that?

With the aid of technology, you could have a nurse fill in that role instead...when people realize that the practical importance of the doctor himself has diminished significantly, then maybe they wouldn't feel the need of personal interaction with the doctor so much?

As I see it, technology might be able to make doctors obsolete... but won't diminish the importance of nurses.

In addition to Nan's response, people are NOT all identical, perfectly built machines. Every one is slightly different, or even greatly different. I really don't think technology will make doctors obsolete by a long shot, not even in the operating room, as has been suggested above. How could you program a computer to handle the huge variety of variables that contribute to the differences in anatomy and physiology, newly emerging diseases, etc., when humans cannot even predict them? As I explain to my med students, we aren't training them so they can diagnose the cases that perfectly fit the textbook description. We're training them to diagnose the vast majority of cases that do not fit the textbook descriptions perfectly, or not at all, or that are new and have never been described before.

I have my doubts that a computer could even perform the most routine surgeries. Yes, for some of them, nurses can, so can residents. When I was in Mozambique, where there is a severe shortage of physicians, indeed, that is what they are doing, training nurses and surgical "technicians" to perform the very routine surgeries and procedures...appendectomies, caesarian sections, set broken bones, etc. However, that involves giving more training to those professionals than they have traditionally been given. But, when there is a complication, they are still not trained to handle it. It gives the patient a much better chance than if nobody was there to do anything at all, but isn't a very good substitute for having a physician nearby who could also save the patient in the case of a complication. Why don't I think a computer can do that? Because even for something like an appendectomy, the appendix isn't in exactly the same place in every person, sometimes it is surrounded by more or less fat, sometimes adhered to the surrounding intestines, longer, shorter, thicker, thinner, sometimes an artery or vein isn't in the usual place (as if there is such a thing as "usual"), perhaps entirely on the opposite side of the body from usual, sometimes encased within scar tissue from a previous surgery, etc.

Now, what about when nothing is where it is supposed to be? Someone comes in with a major trauma, and needs to be put back together again. Maybe a section of intestine needs to be removed and put together, with blood supply redirected to a place that blood supply never normally goes. There's no formula for that. Sometimes, you just have to look at what's still left intact and splice in pieces from other parts of the body to ensure all of the remaining intestines will live. Physicians are the only ones given the level of training to know where every artery in your intestine goes to make sure they pick one that makes sense. We don't teach this to nurses, they don't need it for what they need to do.

And, if we did start training nurses to do this, then what about the jobs nurses currently do? Who will do them? And if you need to give nurses the training to be doctors, why not just call them doctors?

There is a reason there are so many specialties in the health professions, it's because there are a lot of things people need to ensure they have good health.

 

[turbo]

And it's not just doctors and nurses in the spectrum of health-care provision. My sister is a health educator in a rural medical practice and she conducts outreach programs for all kinds of groups of people. If she can provide patients with awareness of their conditions and give them options and some life-skills to cope with them, hopefully they will have better health outcomes than if they only saw a doctor or nurse practitioner on scheduled visits. Some people need a lot more hand-holding and guidance than their doctor or nurse may be able to provide. Elderly people or people with cognitive dysfunction may need periodic follow-up to make sure that they are taking their medications as prescribed and are not dropping through the cracks. Part of the reason that my mother-in-law is getting round-the-clock care from her kids (with some respite from home health-care aides) is that she has dementia, and can easily forget that she has already taken her pills, and will take more, or "remember" that she already took them when she hadn't and take none at all.

 

[Nan]

And it's not just doctors and nurses in the spectrum of health-care provision. My sister is a health educator in a rural medical practice and she conducts outreach programs for all kinds of groups of people. If she can provide patients with awareness of their conditions and give them options and some life-skills to cope with them, hopefully they will have better health outcomes than if they only saw a doctor or nurse practitioner on scheduled visits. Some people need a lot more hand-holding and guidance than their doctor or nurse may be able to provide. Elderly people or people with cognitive dysfunction may need periodic follow-up to make sure that they are taking their medications as prescribed and are not dropping through the cracks. Part of the reason that my mother-in-law is getting round-the-clock care from her kids (with some respite from home health-care aides) is that she has dementia, and can easily forget that she has already taken her pills, and will take more, or "remember" that she already took them when she hadn't and take none at all.

Oh! This is a place where I am hopeful technology and engineering will be able to meet a need in the future. Home assistance for those who are alone, disabled, elderly, etc. is sorely needed. Although a 'robot' cannot meet all the needs of people, the day in and day out needs of basic tasks, taking medications, to notify if a person falls is within the realm and hopefully is being explored. And please, if we can put a man on the moon, can't we have a an assistance device that will clean my bathroom, pretty please? ;-)

 

[avant-garde]

When you compare the salaries of doctors in the US with engineers in the US, vs, doctors in the UK with engineers in the UK, which has the greater ratio?

 

[Sample1]

The future of medicine? I'm obliged to give props to the discipline of Evolutionary Medicine.

 

[gravenewworld]

Future of medicine in the next 20-40 years:

Allosteric modulators (very interesting field)
Protein Kinase inhibitors
Protein-Protein interactions