confessions from a doctor from the 21st century: how doctors travelled from low tech to high tech...
TRANSCRIPT
Confessions from a doctor from the 21st century: how doctors travelled from low tech to high tech
(but actually might consider going back again a bit) Raymond Borger M.D. Vitaalplus
“The physician is only nature's assistant” -Galenus- 129 AD – c. 200/c. 216
Confessions No 1
Confessions No 2
Who’s in for some happy endings ?
What about some free, low risk, easy and pleasurable health promoting interventions (that even might prolong your life a bit?)
contibute to prevention of several diseases increase of vitality raise mental health, mood and quality of life
Ultra-short history of modern medicine we’ve come a long way: low tech to hight tech
Rational research of Galen’s nature: zooming in
Diagnostics
Knowledge & Skills
Rational treatments
Evidence Based Medicine Rational interventions
protocollized medicine based on high quality RCT’s
Ned Tijdschr Geneeskd. 2010;154:A1910. The role of epidemiological evidence in providing care for individual patients. Smulders YM1, Levi M, Stehouwer CD, Kramer MH, Thijs A.
Proven efficacy of treatments based on high quality research
Decline in cancer deaths death per 100.000 citizens
FemalesMalesCases
Year
New Big stakeholders in healthcare
2015
2016
Confession No 2
We’ve come a long way: low tech to high tech an ultra-short history of modern medicine
We ourselves have come a long way too Average lifespan
25-30 years 40 years 80 years
1860 2016Stone age
Life-span vs Health-span
Healthspan
Age related diseases
Total lifespan
Lifespan vs Healthspan
Healthspan
Age related diseases
Total lifespan
€ $
Lifespan vs Healthspan
Healthspan
Age related diseases
Total lifespan
Artificial Intelligence
Lab on a stick
genome editing CRISPR-cas
Personalized medicine
Some great promises for aneverlasting heaven of health
Eternal youthful living
Quantified selfBig data analysis
Genome sequencing
Lifespan vs Healthspan
Healthspan
?
Age related diseases
Total lifespan
Gene editing: who wants to live forever?
1
Science: The good, The bad and The ugly
Confession No 3
Working with protocols based on best available
evidenced base medicine
2
What about….. placebo smoking placebo diet…, placebo exercise…, Placebo clean air placebo laughter…, placebo friendship…, placebo meaningful life…, etc, etc.
major problems with RCT’s3
Substituting approaches in health care…? Zooming out in (rat)race and time
Zooming out: Time
140.000? 6-10.000 150 50
Homo Sapiens
Zooming out: Race (human race)
4 healthy life-style factor23.153 participants aged 35-65 jaar followed during 7,8
- 93% less chance at becoming diabetic- 81% less chance on myocardial infarct- 50% less chance on cerebrovascular accidents - 36% less chance on cancer Healthy living is the best revenge: findings from the
European Prospective Investigation Into Cancer and Nutrition-Potsdam study.
Confession No 4
Hippocratic oath
Healing environment
Evidence based Medicine
Resolving loneliness
TLC
Detoxification
Bio-hacking
Nutrition
Bibliotherapy
Phytotherapy
Biorythm
Stress-coping
Applied physiology
Electrotherapy
Biofeedback
Being in Nature
Cryo & thermo therapy
Nutraceuticals
Big Data based interventions
Laughter
App’s Games
Sociotherapy
Placebo-effect
Pre-/probiotics
Hormesis
Sense of CoherenceSystems biology
Mindfulness
HypnosisSalutogenesis
Health promoting therapies
Enviromental interventions
(Pulsed) Electromagnetic
fields therapy
Effective life-style interventions
Confession No 5
Hippocratic oath
Primum non nocere
2013
? Decline ? of -shared meanigful narrative-sense of coherence -social cohesion ($/€ crisis)-existential skills
Confession 7: I morphed into a health architectR
Examples for serious games for healthGames that facilitate compliance to healthy lifestyle habits -diet -exercise -stress-reduction / stress coping -sleep quality -beating addictions -beating loneliness / creating connectivity -cultivate meaningful narratives -patient education in general -many many more
Rational research of economical data
other rational medical diagnostics & interventions ?
High tech
High knowledge / skillsHigh patent
??
Business model current Medical model Games model
Aimed at (curing) / treating diseases
+ promoting health & Quality of Life
High evidence +++++ / ? - - / ++++
High tech +++++ - - / (+++)
Highly patentable +++++ - - / ?
High skill +++++ - / (+++)
High knowledge +++++ ++++ (creativity)
High risks +(+++) - - - / (+)
High patient autonomy - - +++
Pleasant - - +++
High costs +++++(+++) - - -
patient involvement - - - +++(+++)
Now before we go out ….
….and co-create rational health-care substitutes
aimed at a more healthy, meaningful, awe-inspiring and
possibly even numinous future….
…what about that promised happy endings with some free health longevity-hacks?
Interesting readings