Free Wine, P4 Medicine, and a Small Complaint
Nov 10th, 2011 by amanday9
A little over a week ago I had the pleasure of attending the 2nd Annual Don Rix Distinguished Key Note Address. For those of you not in the know, the ADRDKNA (not a good acronym) started last year as a celebration of the 10-year anniversary of Genome BC. The event is open to anyone who can register early enough. There is free wine (the good stuff too) and free food.
For the first event, last year, Sir Mark Walport from the Wellcome Trust gave an incredible presentation on how advances in genomics can help address the challenges we face in health and sustainability. You can watch is talk here – it is totally worthwhile.
Anyway, the speaker this year was Dr. Leroy Hood who is considered a foundational figure in the world of genomics and proteonomics technology. His talked focused on P4 medicine and its impact on health and society. You can watch his presentation here.
He was not as interesting to listen to as Sir Walport but his topic was really interesting. The idea of P4 Medicine (predictive, preventative, personalized and participatory) really spoke to the tenant’s public health as well as the focus of the social media course I am taking. The other aspect that spoke to me was the systems-level focus of genomics and interactions rather than the focus on single genes.
The shift in thinking that is required to want to prevent disease rather than treat it, to understand that patients have a voice in health, to look upstream – whether it is societal or biological – is massive. One of my favourite parts of his talk was the adamant insistence on democratizing the science and technology of genomics and proteonomics. In other words, no one can own the genome and no one can patent a gene. These gene sequences need to be publicly available to drive research, innovation and over all improvements in health. Open medicine!!
While the topic was interesting, I did have one massive problem with the talk. Despite Dr. Hood’s insistence on democratization and preventative medicine he had very little understanding of the determinants of health. If you watch the Q&A portion of the presentation Dr. Hood starts discussing using this technology to help people understand how their diet influences their blood glucose, cholesterol and overall wellbeing and how that could be used as a prevention for obesity. He then suggests (to my absolute horror) that we should start charging people higher insurance premiums for their poor lifestyle choices.
Now, Dr. Hood is an American and down there health is treated as a commodity rather than a basic human right. Also, Dr. Hood is a geneticist and an entrepreneur, not a public health professional, epidemiologist, or social scientist. Thus, I suppose I should be more understanding of his statement that people should be fiscally punished for their lifestyle choices. Clearly Dr. Hood didn’t understand that often society doesn’t offer the conditions to allow people to make those ‘choices’. Dr. Hood was clearly thinking of his more affluent friends who can afford $1000 protein tests every 6 months and not those in worse socioeconomic conditions who face issues such as a lack of stable income, safe housing, available healthy foods or secure social support networks.
Another issue I had was Dr. Hood’s discussion about this being a participatory process. He didn’t really offer any ways patients could participate and didn’t make any suggestions about how physicians could enable that. Many people during the Q&A brought up issues of physicians using social media and changing the way they interact and empower patients but Dr. Hood was uncomfortable with that technology and had no meaningful comments on this subject.
What I really take home from this presentation were 3 things
- We need to teach EVERYONE about the social determinants of health and make sure they understand what contributes to health and limits ‘choices’
- We need to do more to help physicians understand how to engage and empower their patients – through social media or any other methods
- It’s probably a good thing they serve the wine after the talk.
There is a lot of work to be done folks; we better roll up our sleeves!
Amanda,
This is the type of value-added blogging that blog readers really appreciate. It provides enough information about an important event with a good dose of the blogger’s perspective.
Dean