Today's Practice: Changing the Business of Medicine National Edition Q1 2018 | Page 11

Integrative Medicine
Peter F. Demitry, MD, MPH
art of medicine to those with the doctor-patient
relationship and those with the legal physician account-
ability for each clinical outcome instead of insisting on
the one size fits all paradigm that clearly doesn’t work.
Listen to what it will sound like when personalized and
precision medicine technologies become more than
sound-bytes. The patients are learning and starting to
ask and will soon be demanding personalized and preci-
sion at all levels throughout the health system. Do
we think they will not understand that their differ-
ent genotype and phenotype is irrelevant in the
pharmaceutical selection and dosing without
consequence?
Imagine when insurance
payors truly understand that the savings
gained through endorsing these new
modalities both increase their profits
while simultaneously contributing to
‘good’ medicine and better clinical
outcomes. Yes, doing ‘well’ financial-
ly by doing ‘good’.
Envision being able to see studies with transparent
numerators and denominators and where all studies –
both with positive and all the negative outcomes - are
shared rather than just cherry-picking studies to drive
sales.
Envision a future medical R&D
culture where integrity is never a
study variable and where journal
editors promote multiple diverse
perspectives which are institutional-
ized by the funding sources. Cloning
of research ideas has a record of great
waste. There are so many historical and
current day examples.
Visualize a
vibrantly healthy professional culture of
questioning and critically thinking clinicians
with multiple perspectives and viewpoints,
which is not only tolerated but also welcomed,
encouraged and respected. A swarm of engaged
questioning practitioners will overcome the silos of a
few ‘thought leaders’ purported to solving our challeng-
es. The swarm theory works in many applications.
Consider how your practice could mature with trans-
parent medical data presented in a clinically friendly
format so you and your patients can make truly
informed decisions on how to understand the clinical
risks with associated costs.
TODAY’S PRA C T I C E: C HA NGI NG T HE BUS I NES S OF M EDI CINE
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