Hippocrates, regarded as the “Father of Medicine,” wrote “It is far more important to know what person the disease has, than to know what disease the person has.” Though the concept itself has ancient origins, modern medicine is revisiting the idea of personalized medicine, charting new territory through technological advances and a more individualized approach to patient care. The days of a “one size fits most” approach to health care are on the wane, with physicians adopting a “Prescribe the right care plan, for the right patient, at the right time” mentality. This approach to health care, which incorporates personalized factors such as an individual’s genetic makeup and other predictive factors which could impact the efficacy of a course of treatment, is generally referred to as personalized medicine. Individualized medicine, precision medicine, and P4 medicine are other terms commonly used to describe this approach to health care and drug therapy.
Let’s say that your body is a dressmaker’s model, and that both your disease and treatment are a shirt. Even with the modern world’s technological advances, medicine is still as much an art as it is a science. As such, each body experiences disease in its own specific way, and though physicians can predict the most common paths that most bodies experience during the course of both disease and treatment, there will always be outliers on either end of the spectrum. Though disease itself may be an “off the rack” shirt, the way in which it progresses is like the hang of the shirt: though it may be the same garment, it looks very different on each person who wears it. Personalized medicine, then, is like a tailor: customizing the treatment to the body and thus creating a better fit. Simply put, personalized medicine (individualized medicine, precision medicine, P4 medicine) is the idea that each person’s unique makeup (physical, genetic, and environmental) creates a very specific landscape through which diseases move. The term P4 medicine defines the central tenets of personalized medicine: Predictive, Preventive, Personalized, and Participatory. Through technological advances, such as genomic testing and biometric screening, doctors can better predict which diseases a patient may be at risk for in the future. This prediction, in turn, allows the doctor and patient to create a personalized plan for prevention of disease, which is participatory in its nature, as the patient works with their doctor to create preventative health plans, as well as treatment plans if and when a disease is diagnosed.
20th century medicine was defined by a “trial and error” approach to courses of treatment, with the underlying idea that “one size [treatment] fits most.” As technology has advanced, physicians are now able to narrow the scope of treatment by separating patients into different groups and “prescribe smarter.” Through personalized medicine, rather than waste precious time and money on “trial and error” prescriptions, doctors have better tools by which to predict both a patient’s unique susceptibility to disease and the likelihood of drug therapy to be effective. Personalized medicine allows doctors to “weed out” medications with less potential to be effective, or with which the patient is more likely to experience harmful side effects. This allows both patient and physician to make better-informed medical decisions. Better-informed medical decisions lead to a decrease in adverse side effects (with a greater likelihood of successful treatment), and a reduction in long-term health care costs by focusing of the preventive/predictive aspect of disease over the treatment of symptoms after a disease manifests. Though lowered healthcare costs and an increase in the quality of clinical care are definitely a driving force behind the rise in personalized medicine, the defining characteristic of this approach to medicine is the human element. Personalized medicine enhances the overall quality of life for patients by identifying risks, treating the body for these risks before it becomes symptomatic of disease, and avoiding treatments that are unlikely to be effective or which would cause the patient to experience adverse or harmful side effects. At its core, personalized medicine is proactive and patient-driven, instilling patients with a sense of control and confidence in the precision of their treatment. Recently, the FDA approved 10 screening tests for genetic health risks provided through personal-genomics company 23andMe. These FDA approvals represent a pivotal moment in democratizing 21st century health care through ease of access, as these screening tests are affordable to many patients who would otherwise opt out of more cost-prohibitive preventative medical screenings. The ultimate goal of personalized medicine is the streamlining of clinical decision-making by only prescribing a course of treatment to patients that are likely to benefit from it.
