brannsiu :
in the past 30 years we can see the breakthrough in terms of technology, when there was no home use internet, using bulk telephone lines, black and white pager machine, delivering paper mails, to now, internet world, colourful touchscreen mobile devices, get in touch with everyone else on the internet instantly
but it looks like to me that we have little or no medical advance. Most incurable diseases are still incurable now, Cancer is still very difficult to cure, many chronic diseases could still only be manged, controlled, but not cured totally, while the patients may be suffering physically and mentally for the rest of their lives. Yes, there is some advance, but most likely they are "technological" advance instead of the breakthrough, the successful rate of some surgery increased, however, it looks like there is never a magic bullet to cure any
serious or moderate diseases.
Is our body still so difficult to understand totally? what do you think?
The relatively small impact of computers (which is what you are really referring to as "technology") on medicine compared to the massive impact of computers on some other fields such as media has surprised, confused, and disappointed many people. To be truthful, nearly all of the people surprised, confused, and disappointed by this are not medical professionals and are typically older Baby Boomers who grew up watching sci-fi such as Star Trek and were indoctrinated with "space-age" thinking that computers could do miracles and we would all have flying cars, tricorders, and computers would solve world peace, poverty, and hunger. Those of us actually working in the medical field and young enough to have grown up in the era when computers started to make their way into general usage rather than being something taking up an entire room far, far away in some secret government lab's basement are not surprised at all.
There have been hundreds of billions of dollars spent just in the last 8 years on computers in medicine. The federal government from 2009 on had made it a priority to force computers into healthcare with a series of laws and regulations impacting Medicare reimbursement. Medicare pays for about 2/3 of the volume of healthcare services in the U.S., so they essentially control the entire healthcare system. The impact has been very minimal as you have noted, and many studies such as the recent Annals of Family Medicine and Annals of Internal Medicine studies which have shown that forcing computers into healthcare has done nothing more than drive up costs by the hundreds of billions of dollars that were paid to the various third parties now involved (electronic chart vendors, IT personnel, HW vendors, data storage services, regulatory compliance personnel, etc. etc.) It has also greatly decreased the effectiveness of medical personnel who are now spending the majority of their time futzing around with the computers instead of providing care, and has largely driven physicians out of private practice into either employed roles for monopoly hospital systems, into retirement, or out of the field entirely. This has especially impacted primary care where those physicians spend 2/3 to 3/4 of their time doing unpaid computerized busywork and has greatly exacerbated the shortage of those physicians.
There have been a large number of academic papers regarding what actually affects longevity and health, particularly since chronic diseases mainly affect the over-65 age range and in the U.S., the federal government promised the over-65 age group they would pay for their medical care with Medicare. This has caused massive expenses to the U.S. federal government which already runs large deficits and a $20T debt, and the primarily federal government-funded academics have been looking at how to reduce that. The results they have found in general (summarized in a JAMA article from about a year ago) are that poor lifestyle choices such as smoking, obesity, substance abuse, and lack of exercise account for about 50% of chronic disease related costs, genetics account for about 40%, and the impact of the healthcare system is <10% on this. JAMA also published a study in the fall of last year that did a sociodemographic and geographic breakdown of life expectancy and found the biggest cause of reduced life expectancy to be living in an area with a culture of poor health habits, as poor people live about the same lifespan everywhere but more wealth individuals' lifespans vary significantly based on location, ostensibly due to culture. I'd cite these for you but unfortunately they are paywalled.
Nearly all chronic diseases have a genetic predisposition if not a genetic cause, which is why family history is such an important risk factor for them. We do not have any way to change one's genetics at the present time so these diseases must be managed/controlled with chronic treatment of some sort. Unless and until we do, this will remain true.
The human body is incredibly complex. We understand some things well, and many other things are not completely understood. However, we have only been studying the human body using modern scientific methods for a little over 100 years, so it is not surprising we have not figured it completely out yet. Humanity has been studying natural phenomena such as weather for much longer as we still don't understand it completely.
One thing we will NEVER, EVER fix with computers will be human behavior. That really only can be changed in nearly all people by making certain behaviors socially desirable or unacceptable. (Look at smoking, it has been proven and very publicly known since the mid-1960s that it is unhealthy, yet about 1/4 of the population still smokes and nearly all of them currently smoking started *after* we knew it was harmful.) We have millions of years of "human nature" in our past and a lot of reasons why it is what it is...and people have been trying and failing for millennia to change it. Einstein said that continuing to do the same thing repeatedly and expecting a different result is idiocy; that applies perfectly to trying to change human nature.
Facebook
Twitter
Instagram