Term "Personalized Medicine" More About Business than Healthcare Delivery

I have always had a sense of vague unease about the use of the term personalized medicine because I never quite understood what it meant. I also quickly learned that it was subject to misinterpretation by healthcare consumers and patients. For example, I have heard many of the latter define it as healthcare delivery that is tuned to their special and personal needs including, for example, the quality of the hospital food. I much prefer, as a substitute, targeted therapy which to me refers to the development of specialized biotech drugs that have the capacity to kill malignant cells without harming the patient host.

Mr. HIStalk articulated the basis of my discomfort with the term in a  recent brief note. As he correctly points out, it's a mere marketing slogan designed to attract investors to biotech stocks but not accomplish much else. Below is a short quote from his note:

Stanford Hospital and Clinics is involved with the Personalized Medicine World Conference, running now in Mountain View, CA (see: Silicon Valley to host conference on 'personalized medicine'). Attendees were “investment bankers, investors, attorneys, accountants and entrepreneurs,” so that pretty much says all you need to know about the business aspects of US healthcare.

Putting all of this together, the term personalized medicine should be viewed as an adverting and marketing term, which is defined in the following way: ...short, often memorable phrases used in advertising campaigns. They are claimed to be the most effective means of drawing attention to one or more aspects of a product. A key element of medical science is that terms need to be concise, understandable, and immutable. This avoids errors and harm to patients. A marketing program and the phrases associated with it, on the other hand, are designed to avoid clarity and precision. The goal is to lull the potential buyer of stocks or investor in "personalized medicine" companies into a comfort zone. He or she needs to feel good about companies but not quite understand what they do to make money.

Comments

[Ajit Alles]

I agree with you that this is primarily a marketing tool for the genomics/proteomics brigade. This has come to mean that patients will have personal physician concierges. If we had unlimited funds that might be possible, but without utopia close at hand, the reality is that medicine will be based on statistical norms for the most part. We had a kind of personalized medicine when medicine consisted of the family doctor practicing by himself, but we have rejected that model in an attempt to streamline and rationalize medical treatment. While this has produced good outcomes we have lost the personal interaction with our doctors. We may be able to tailor our therapies, but concierge medicine will only be available to the wealthy. The rest of us will have to lump it.

[Brian Jackson]

Bruce,

I think you're being too narrow when you define personalized medicine as targeted therapy. (Though you're much more on the right track than the vast majority of biomedical folks who think it means simply performing whole genome analyses on everyone.) Given that we're pathologists, how about we define personalized medicine in terms of the information integration necessary for patient care? The two ends of the spectrum in my mind are population medicine and personalized medicine. Population medicine is essentially EBM. It gets criticized for being cookbook, but the fact is that there is important information value in studying large groups of patients at a time -- think where we'd be if randomized clinical trials didn't exist. At the other end of the spectrum is personalized medicine, i.e. acquiring and integrating more and more patient-specific information. I firmly believe the sweet spot will be when we figure out how to properly balance and take advantage of both population-based information and personalized information and apply that to individual patients.

--Brian