Blog | Thursday, September 26, 2013

AAFP: Conflicting ideas

My second AAFP session of the morning was about patient engagement, and how communications technology and a better understanding of patients' perspectives could combine to eliminate all the problems of medicine, especially that pesky nonadherence to your advice. I'm not exaggerating. Literally, the speaker told us that "The family physician's office of the future will have no one in the waiting room, because everyone's healthy." Or those few who haven't been prodded into health will be identified for pre-emptive action by "red lights" in the electronic health record.

And then the next session was about genetics, and how in the future, gene testing will be widespread and the ability to know what diseases patients are at risk for will change the course of medicine. We'll have prenatal testing, perinatal testing (how all this knowledge will be acted on, we didn't get into) and pharmacogenetics to tell us which drugs to take.

Seems like a bit of a contradiction there, no? It might be convenient if our health were entirely determined by our behavior or our genes, but the reality seems a lot more complicated. Sometimes we get sick for some reason that has nothing to do with either, as was pointed out by a questioner in the gene session who has Parkinson's, but had helpfully learned from 23andme that he's at low risk for the disease. I'm sure both of these expert speakers actually know that health is more complex, but it's useful to remind ourselves of this when we're tempted to trumpet a cure for the challenges of health care.