Anticipatory Healthcare: Predict and Prevent

There's incredible value in foresight -- in business, in government, but most of all, in your personal life. And nothing's more intrinsically, existentially valuable than foresight about your own health. If you could know what will happen to your body based on the way you treat it now, along with your genetic profile, would you make lifestyle changes to prevent those problems from happening?

A Future Fact about health care is that technology is providing the tools for it to become more anticipatory. We're seeing a shift from the current model to one that's more predictive, one hinging on foresight and a combination of the right technology and analytical knowledge -- what I would call the Predict-and-Prevent model of healthcare.

The prevailing trend in healthcare today is best described as a Break-Fix model. This paradigm is all about being reactive instead of pre-active to future known events -- treating problems as they occur with medicine that only addresses the problem itself instead of the problem's cause and the issues it might lead to in the future.

I'm willing to bet most people reading this piece have had a sinus infection at some point in their lives. It's a pretty loathsome affliction, but it's common enough to affect a huge portion of the American populace on a semi-regular, if not regular, basis. You've probably gone to the doctor with a sinus infection at least once, only to be diagnosed, given antibiotics, and sent home to convalesce. But that probably wasn't your last sinus infection; maybe it was just one of many. If so, you've perhaps found yourself continually returning to your doctor with this malady, returning to his one-off diagnoses and cursory, chicken-scratch scrawling of your usual prescription -- returning to the break-fix model of medicine.

If you'd gone to a doctor who subscribes to the Predict-and-Prevent medical school of thought, your first sinus infection might have been your last. The doctor would have diagnosed you with a sinus infection, of course -- but then, instead of sending you home with a script for antibiotics, he would've started asking questions: Have you ever gotten a sinus infection before? How often do you get them? Maybe he'd have examined your septum and found it deviated, recommending minor surgery to fix it. Or perhaps he would have asked whether you've had a family history of sinus infections, meaning you might be genetically prone to them for one reason or another. He might have decided to give you an allergy test and found a food allergy that you can control or an allergy to a specific plant that's made you particularly susceptible. Whatever the reason, he'd have figured out the cause of your sinus infection and worked with you to correct the issue -- not just temporarily, but permanently.

This is what the Predict-and-Prevent version of healthcare is all about: solving tomorrow's predictable problems today.

This anticipatory model of medicine doesn't just have value in its smaller, more immediate applications, however; it can be used to address the most serious and seemingly inexorable diseases. It's a Hard Trend (a trend that will happen) that the cost of genetic testing is dropping, and mapping sequences of DNA and even entire genomes has never been easier. Every disease has a genetic marker, and we're identifying more diseases by their genetic traits every day. There are thousands of genetic diseases we can test for now, and that number continues to grow.

Let's say you're a smoker. You go to your doctor today, tell him you smoke, and he strongly advises you to quit but does nothing more. An anticipatory doctor might ask if your family has a history of lung cancer; he might then give you a genetic test and find you're predisposed to lung cancer. Which doctor would have a better chance of getting you to quite smoking?

This notion applies to other preventable maladies like diabetes and heart disease, especially when associated with dietary or lifestyle choices. Sure, we've seen plenty of documentation of elderly people who smoke, drink, eat poorly, or don't exercise, but the reason these people have lived into old age is likely that they're not genetically predisposed to certain diseases -- cardiovascular disease and some types of cancer being among those illnesses. But they're the exceptions, not the norm.

Part of the Predict-and-Prevent model relies around using major lifestyle or behavioral changes in patients to avoid sickness wherever possible. But in order to do that, a patient needs to be convinced of the necessity of change. Today's doctors all to often look you over, run some basic tests, and give you the same advice: "Eat better; exercise more often."

Anticipatory doctors, however, will use a combination of technology and detective work to properly inform their patients and present them with irrefutable evidence changes in behavior or lifestyle need to be made. Technology that makes the invisible visible with ease is becoming increasingly available -- and when you're staring at an image of plaque forming around your arteries, it'll be pretty difficult not to want to eat better and increase your daily exercise,, maybe you would make yourself a salad instead of that cheeseburger you were thinking of.

Here, we run into a problem, though. What's the incentive behind this model? Any doctor that fixes a patient's problem permanently or excels at keeping his patients healthy is, in terms of the current medical industry, bad for business. The break-fix model will keep patients coming back again and again to treat recurring problems thus keeping healthcare expenses high. Thus, the idea of a patient continually having to return for the same problem or issues related to a perhaps correctable root cause should be music to the ears of a medical facility or doctor who only knows how to profit from the break-fix model. But this notion is backward; when doctors act in a more anticipatory manner, patients will keep coming back because they'll trust their chosen medical professionals. They'll recommend their doctors to their friends, and business will grow. Creatively analytical, anticipatory doctors -- the ones who use advanced technology and ask better questions, and in doing so, take a holistic approach to Predict-and-Prevent medicine -- will be the most in-demand because they're not only improving their patients' overall quality of life, they're ostensibly saving more patients' lives.

Sooner or later, the average American will pick up on the shift from break-fix medicine to Predict-and-Prevent, whether it's because they've become more aware of the relationship between lifestyle, genetics, and preventable disease, or simply because they haven't gotten a sinus infection since their last visit to their anticipatory doctor -- and most likely won't get one again.

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