Innovations in the way health care is delivered that most physicians have at the start of their careers coming into the field should provide hope for the future of medicine, according to a speaker at the 2022 American College of Mohs Surgery. Annual Meeting held. May 12 to 15 in Philadelphia, Pennsylvania.1
In a keynote session, Marty Makary, MD, MPH, surgeon and public policy researcher at Johns Hopkins Medicine, in Baltimore, Maryland, told the audience that these innovations will mean a systematic change in how health care will be provided.
“‘ Holistic care ’doesn’t get it,‘ precision medicine ’doesn’t get it,” Makary said, as these phrases are not enough to describe some of the changes being discussed. to the medical schools and to the doctors who participated. the profession. “They asked‘ should we take care of more diabetic patients with cooking classes as opposed to medicine, ’‘ should we talk about school lunch programs like talking about bariatric surgery, ” should we treat more high blood pressure. patients with stress management instead of throwing antihypertensives at them ‘? “
These solutions are needed, he said, because our current health care system is in crisis. He boiled down the current health care crisis to 2 central drivers, particularly the suitability of care and pricing failures that created an open door for the “human-middle industry. , ”which sets prices and makes it difficult to provide quality care at one price. to be managed by the majority of patients.
As an example of inappropriate care, Makary points to the numerous studies that exist on antibiotic administration that is sufficient to manage about two-thirds of appendectomy cases, and yet this surgery is routinely performed. .2 “Our fellow surgeons in Europe laughed at us, saying‘ we’ve done it [antibiotic treatment] for decades, but adoption is slow here, ”he said.
In another example, Makary said it has been common practice for some time to recommend daily low-dose aspirin to prevent heart disease. He said recently released recommendations from the U.S. Preventive Services Task Force now reverse this recommendation for adults age 60 and older.3 He said growing evidence suggests that this practice can lead to gastrointestinal issues and potential strokes, and getting this information is what he says needs to be done to set appropriate treatment targets. -atiman. “The best way to lower drug prices in the United States is to stop taking drugs we don’t need,” he said.
Speaking of price points, Makary said health care cost problems are systematic, even up to the National Institutes of Health (NNIH). “In 2020, the NIH spent 2.2 times the aging research we did on COVID-19 research,” Makary said. “Now look, I’m all for research on aging, but not during a pandemic.”4
Another issue is the price of the drugs themselves. One only has to look at their local pharmacies to see the many differences in the prices of medicines used by patients every day to witness the systematic problems of health care pricing, and no that takes into account the differences in insurance payments and payment structures.
So, what is the response to this crisis? Makary said the way the medicine is delivered will change. And the good news is that these changes are coming, he said.
“Social justice is a generational value,” of medical school graduates, Makary said, and that, he continues, is likely to provide a better future going forward.
- Makary M. The grassroots movement to redesign health care-preparing for the future of medicine. Presented at: 2022 American College of Mohs Surgery Annual Meeting; Philadelphia, May 12-15, 2022.
- A randomized trial comparing appendectomy antibiotics for appendicitis. NEJM. 2020; 383 (20): 1907-1919. doi: 10.1056/NEJMoa2014320
- US Preventive Services Task Force, Davidson KW, Barry MJ, et al. Use of aspirin to prevent cardiovascular disease: a preventive services statement of the task force recommendation. JAMA. 2022; 327 (16): 1577. doi: 10.1001/jama.2022.4983
- Funding Estimates for Various Research, Conditions, and Disease Categories (RCDC) Report. Accessed May 13, 2022. https://report.nih.gov/funding/categorical-spending#/