Bridging the gap between reactive healthcare and proactive, personalized prevention

In recent years, medical professionals interested in applying a more proactive standard of care have coined the term “Medicine 3.0” to describe the next stage in the evolution of healthcare.

The term refers to the history of medical care dating back thousands of years: Medicine 1.0 predates the scientific method; therefore, early medical care was in reaction to an ailment or wound, and the subsequent treatment was a best guess about what might work.

Medicine 2.0 is where we’ve been since Francis Bacon introduced the scientific method in 1620, providing a framework for medical professionals and scientists to prove (or disprove) a hypothesis for successful treatment.

Medicine 2.0 has given us numerous breakthroughs in medication, surgical procedures, vaccines, antimicrobial therapy and more. But the reality is that when adjusting for deaths due to infections, life expectancy has not increased as much as you might think in the last 100 years. Why? Despite the incredible breakthroughs in acute care, Medicine 2.0 still operates within a reactionary paradigm. Enter the promise of Medicine 3.0, which looks to apply a proactive standard of care that doesn’t wait for people to develop disease but looks to prevent chronic disease whenever possible.

We see the beginning of the Medicine 3.0 infrastructure being built every day by innovative companies looking to test, monitor and intervene within the type of time horizon required to prevent the chronic diseases of modern civilization. This is accomplished through a variety of advanced clinical and at-home testing protocols, wearables and other smart devices that produce biometric data that can be analyzed and synthesized into insights by AI-based algorithms.

As with almost every technology-based evolution, most of these solutions are still costly as companies need to factor their R&D costs into their pricing, and our existing insurance-based model has been slow to recognize the value proposition summed up by Ben Franklin when he said, “An ounce of prevention is worth a pound of cure.”

Where Are We Now?

My recent annual physical was a good reminder that while we are moving towards Medicine 3.0, we are still not there yet. Therefore, I would characterize our current position as Medicine 2.5, and as with every messy middle, how to navigate it matters. So here are some thoughts on how to proceed along the bridge to Medicine 3.0:

  • Find a general Practitioner who:
    • Sees the patient as the customer, not the insurance company as the customer. Our current system’s incentive structure is horribly misaligned as insurance companies apply a short-term mindset to cost reduction
    • Is open-minded and informed about the new products and services meant to compliment their role, not to subvert it. I hear so many stories about GPs who push back against the use of testing alternative biomarkers, devices and other preventative-based interventions, often because they are unfamiliar with them. And I get it, GPs are often overworked and underappreciated, but your primary care needs to be a partnership and I would do your best to find a GP who recognizes that
    • Understands the difference between population-based risk and personalized risk adjustments identified through genetic testing, family history, comprehensive biomarker testing, environmental factors, etc
    • Recognizes the importance of staying ahead of disease and is willing to err on the side of a proactive, personally risk-adjusted treatment approach versus a passive wait and see approach
  • Medicine 3.0 things to know and monitor:
    • Genetic reports and/or family medical history – third-party vendor
    • Blood pressure – automated blood pressure cuff
    • Lipid profile (including Apo(a) and ApoB) – blood panel
    • Fasting glucose/insulin and hemoglobin A1C – blood panel
    • Homocysteine – blood panel
    • Uric acid – blood panel
    • Waist circumference – tape measure
    • Visceral adipose tissue (VAT) – DEXA scan
    • Body composition – DEXA scan
    • Bone density – DEXA scan
    • Functional Zone 2 output and/or Vo2Max – bike or treadmill test
    • Grip strength – hand dynamometer
    • Resting heart rate (HR) – wearable
    • Heart rate variability (HRV) – wearable
    • Respiratory rate (RR) – wearable

Everyday Takeaway

In the interest of making the most of our health, wealth and time, it behooves us to get as close as we can to Medicine 3.0 as soon as possible. And because we can only control what we can control, my advice is to use the information above to create a proactive system of data collection, monitoring and evidence-led intervention.