Disease is Dead. Long Live Treatment

Well, not exactly but disease should be dead and treatment should be reigning. In the 21st century, as we delve into the minutiae the body, the smaller we can see, the more we describe and define. But by using old methods of disease description we continue to differentiate rather than unify concepts and this results in an epidemic of disease proliferation.

This phenomenon is fuelled by international recognition. In nearly two decades – the time it has taken the World Health Organization (WHO) to move from the ninth to the to the tenth edition of the International Classification of Diseases the number of disease codes has almost doubled from 7600 to 14000 and yet less than 4% of UK clinicians access these data in their daily work.

When diseases outstrip treatments medicine runs the risk of becoming an observational science rather than an interventional one.

The procedure index, which is the ratio of new procedures to new treatments, has remained at a lowly 20% for several years. That means for every five new diseases that are named, only one new treatment or procedure is developed.

When diseases outstrip treatments medicine runs the risk of becoming an observational science rather than an interventional one. The proliferation of diseases without accompanying treatments has a poor prognosis for both providers and consumers. Everyday, new diminutions of diseases populate our airways (like systemic sclerosis overlap syndrome ).

The last thing we want to hear is that we have a disease that has no cure, afterall such a prognosis in the hands of health insurers will be quickly deemed unfundable – just as we have seen with the exclusion of natural disasters from home insurance.

The good news is that there are remarkable similarities across the body in the way health problems are managed – irrespective of whether you’re talking a kidney or a joint – simply through the classification, and with it a reorientation of medical thinking, that is based on effective treatment at a molecular level not a disease. We now have therapies that cross bodily geographies eg monoclonal antibodies, checkpoint inhibitors, anti tumour necrosis factor etc. They know no organic boundaries and can work across many locations in the body.

We saw this happen in the last century where antibiotics and anti-inflammatory agents were found to work across a variety of diseases, so there seems to be no reason why newer treatments can’t be seen in the same light.

One thought on “Disease is Dead. Long Live Treatment

  1. Well as each Thinker hits my “in box” I am excited to read the refreshing approach that you have to cypurrent Medicial issues that concern us all today . With each post I learn how it is not only the Drs that dictate our fate … We the general have a say and an opinion …. Which has often been lost in the Dr patient relationship …. Reading the Thinker gives me hope for the future …..keep it up

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