Medicine is not just a science. It is a living practice. Translating emerging science into practice is one of the key skills of doctors. Before scientific knowledge became viral, translation was merely a matter of communication. Now, as the science of medicine reaches epidemic proportions, it is becoming more and more difficult to perform this task using our traditional tools.
For example, classifying diseases is becoming obsolete in practice. The number of disease classes is too large, and it is impossible for doctors to explain this terminology in a meaningful way with patients. In nearly two decades, the number of new diseases invented or discovered has almost doubled from 7600 to 14000 and yet less than 4% of clinicians access these disease names in their daily work.
The science of medicine is a communication dinosaur. It needs to move rapidly into the audiovisual age before it becomes extinct.
Irrespective of the label, one thing most human diseases have in common is that they manifest in living people and not in the pages of a dictionary.
Part of the problem is that our written and spoken language is inadequate. Take the English language. There are 171,476 words in current use, of which over half are nouns, a quarter are descriptive words such as adjectives, and about a seventh are verbs. The rest are exclamations, conjunctions, prepositions and suffixes.
Hardly enough to describe the complexity of multiple conditions and how they might interact in even one patient over time. The science of medicine is a communication dinosaur. It needs to move rapidly into the audiovisual age before it becomes extinct.
In some areas of medicine, such as radiology, where visualisation is essential, diagnosis by retrieving visual images is well established. These images are computed in one of two ways, either by text and or by content. The old fashioned text-based approach involves experts translating the visual images that they see into clinical descriptions. The newer content-based approach uses visual information to develop an image dictionary.
The therapeutic descriptions in medicine must catch up in this media driven world. We need to create a visual bag of scenarios. Accessing the video medium to transmit complex concepts and treatment pathways that occur over long periods of time must be part of this century’s medicine.
The Thinker 
This post made me think differently about communicating diagnoses. We have used visual imagery for dermatology and radiology, it is not a stretch to apply it elsewhere though I see it as complementary to text for internal medicine. As for family medicine, narrative cannot be replaced – we have tried that in the past. We know that diagnostic labels are insufficient, hence ICPC was invented- but ordinary docs don’t use it. Sometimes it is the story that we ‘treat’, and not a diagnosis at all.
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