MURDER, POLITICS, AND THE END OF THE JAZZ AGE
by Michael Wolraich
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The Breakthrough of Instant Diagnosis
By EmmaZahn on Fri, 11/22/2013 - 9:29am |
'The reality within our health-care system today is that when someone you care about gets really sick, by the time you find that out it's most often too late to do anything about it. It's heartbreaking. Because in those moments, there's nothing you wouldn't do to change it, and too often you're helpless," says Elizabeth Holmes. "We're finding cancer when you have a tumor, or heart disease by virtue of the fact that you're having a heart attack." [] She wants to change that. [...] The secret that hundreds of employees are now refining involves devices that automate and miniaturize more than 1,000 laboratory tests, from routine blood work to advanced genetic analyses. Theranos's processes are faster, cheaper and more accurate than the conventional methods and require only microscopic blood volumes, not vial after vial of the stuff. The experience will be revelatory to anyone familiar with current practices, which often seem like medicine by Bram Stoker.
URL:
http://online.wsj.com/news/articles/SB10001424127887324123004579055003869574012
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Comments
New medical technologies tend to be over-hyped promises of a possibility sometime in a vague future. Theranos is different in that it is being implemented now in partnership with Walgreens and with the implied backing of the military. Expect it to succeed.
by EmmaZahn on Fri, 11/22/2013 - 9:55am
It's an exciting development but I totally disagree with this article's conclusions about what it will do for patients.
Test data is wholly and totally dependent on the skill of the diagnostician to interpret what it means. And only a select few of our health care practitioners are good at that, and those that are are, in our current system, are often not paid in ways that encourage taking the time doing to do that correctly.
I have up close and personal recent experience with a loved one. He had been experiencing lots of strange whole body symptoms and an eye doctor concurrently noticed something wrong, something he could not interpret. The loved one got sent to lots of specialists to rule all kinds of things out. Still no diagnosis. He was sent to a "expert diagnostician" well regarded by more than one of the specialists, who ran a gazillion bodily fluid tests at much $$$ cost, resulting in reams of reports. From that, the diagnostician knows a lot about my loved one's body functions and even his habits around the time of the tests, but still does not know what caused all those symptoms, which have mostly resided. Who knows what was wrong with him and what might still be wrong with him and might flare up more dangerously in the future? Not the tests and not any of the doctors who looked at them.
Adding to the complication, the loved one is not a good patient. He does not focus on his body and health but tries to will symptoms away, and furthermore hides certain bad habits from doctors. Therefore the doctors are further handicapped in interpreting the meaning of test results.
by artappraiser on Fri, 11/22/2013 - 11:05am
P.S. There is a very useful example in the recent news. There are tests for "good cholesterol" and "bad cholesterol" that are currently done on most patients during physicals. What do these results mean and what should be done about them? The powers that be aren't sure anymore.They aren't even sure anymore what the numbers mean! And they don't know whether after being put on statins people should even pay attention to them!
What I am saying is that making testing of all kinds of things easier and more accurate and cheaper could just as easily mean lots of bad medicine just much as it could mean better medicine.
The practice of medicine is an art. Tests are science. The science is just a tool to make the art.
by artappraiser on Fri, 11/22/2013 - 11:12am
When you want a correct diagnosis for an obscure pathology, get a female internist. Just sayin'.
by jollyroger on Fri, 11/22/2013 - 11:46am
Wimmin's intuition, eh? Why you male chauvinist you...
Actually, I had a black male physiatrist a year ago (very testosterone-y as well, a practicer of martial arts, shaved head, looked like a marine sergeant) with whom I was most pleased in this skill. When I explained my reasons for a preference not to have an MRI after X-rays, along the lines of fear of ending up putting blame where it might not actually be, he said he would still prefer to have the MRI data, but that I shouldn't fear because---
I treat the patient, not the test.
No better words can one hear from a doc! We went on to work as a team. That required me doing some homework on the internet about anatomy so I could target my own symptoms and report back to him.
Suffice it to say my problems worked out very much to my satisfaction using just our two brains and two very targeted cortisone shots, a course of meds with some therapy, along with targeted vitamin supplements. Instead of surgery on something degenerative that would have showed up on an MRI (which I never got, BTW) that might not have caused the trouble. The nervous system is a mysterious thing, we are in the infancy of understanding it.
He was Harvard Med School trained. (I actually asked him how can he still be so nice with such a fancy degree?) Seems to me lately that a lot of good stuff I read on medical practice is coming outta that unit....elitist with good cause to be so?
by artappraiser on Fri, 11/22/2013 - 12:44pm
Wimmin's intuition Hmmm. If a gun were put to my head, I would deconstruct the study results (can't find the study, but I remember it from somewhere) as resulting from the fact that women know how to *listen and thus get better histories...
*(perhaps "know how to listen" ought to be "have been forced over the years to endure listening to droning bores")
by jollyroger on Fri, 11/22/2013 - 4:14pm
I totally agree with you about the current state of diagnosis and that this is not a grand panacea and that it will initially result in more, not less, misdiagnoses. That stipulated, its promise for improvement of the field is tremendous: testing with small samples, quicker turnaround, cheaper!, self-monitoring!.
Of course, the many, many doctors who own labs will hate its general availability. I suspect that it was their anticipated resistance and co-option of the technology that kept it such a closely-guarded secret until it was ready to be deployed. No doubt the military backers helped there. Nevertheless, I expect it will be quickly adopted in those doctors own labs as well.
The dark side is still an open question. The combination of the military's interest and genetic testing implies the possibility of a DNA registry. Something else for Greenwald to obsess over. Not that it does not bother me, too, but I do not see anyway that was not going to happen eventually anyway and at least we may get something useful in return.
by EmmaZahn on Fri, 11/22/2013 - 11:38am