In nearly 30 years as a doctor, I’ve come to realise that the most powerful tool in healthcare is quite simply time.
Most patients are somewhat aware of this. They know that whether you’re talking about heart disease or cancer, the earlier you get treated, the more likely you are to make a full recovery. But that’s just one small piece of the healthcare-time puzzle.
The other pieces are tackled in “Medicine 3.0” – an updated way of thinking about medicine that has gained popularity in recent years. Canadian-American physician Dr Peter Attia coined the term, and explores it in his book Outlive: The Science & Art of Longevity.
Briefly, Attia characterises Medicine 1.0 as the period of human existence where illness and healing were treated as things that were largely out of our control. In about the last two hundred years, major developments like germ theory, the discovery of vaccines and the development of modern medicine have ushered in the era of Medicine 2.0.
Average human lifespans have doubled since the 1800s – an incredible achievement if you consider that they barely moved for more than 200,000 years.
Attia argues that thinking about longevity in terms of lifespan alone is unhelpful. Instead, he says, we should be aiming for a longer “healthspan” – how long a person lives free of ailments, disease and pain. After all, living to 90 is only wonderful if you’re able to enjoy your golden years, feeling active, happy and relatively strong. This is essentially what Medicine 3.0 is all about.
What does this have to do with time? Everything.
If there is one thing I think every doctor in South Africa will tell you is that whether you’re in the public or private sector, you simply do not have enough time to spend with a patient.
According to World Bank data, there were around eight doctors per 10 000 people in South Africa in 2021 – compared to around 70 in Sweden, 40 in Australia, and about 30 in the United States and the United Kingdom (while higher than South Africa, these ratios are not great either).
This means that typical doctor-patient interactions are, out of necessity, quick and reactive. The system is designed to treat the sick, looking after your lifespan, but not allowing for the holistic and personalised care that increases your health span. Holistic care would ensure treatments from various specialists complement each other. Personalised care would ensure that these treatments are based on your unique physiology. What this requires, more than anything else, is time – which, again, is currently in short supply for the average doctor.
No surprise then that the South African Medical Research Council recently found that one in five South Africans suffer from more than one chronic illness, and Statistics South Africa found that deaths due to non-communicable diseases – comprising cardiovascular diseases, cancer, diabetes and chronic lower respiratory diseases – increased by nearly 60% between 1997 and 2018.
Now, imagine how those numbers could shift if time were on our side.
In an ideal Medicine 3.0 scenario, you would visit your doctor regularly before you fell ill. You would undergo a comprehensive screening, analysing the current state of your health and your risks. And then, you and your doctor would work towards mitigating, even eradicating, those risks.
If you think this approach sounds expensive, studies have shown quite the opposite.
Meeting and mitigating healthcare risks early results in significant savings in healthcare costs (in the region of billions of rands) for countries, by limiting the need for hospitalisation, surgery and more intensive treatments such as radiation or chemotherapy. The savings are more significant if you factor in the fact that the loss of income people experience when they have to stop working due to prolonged, chronic illness is avoided.
In other words, Medicine 3.0 means that instead of undergoing a long, painful recovery after getting ill, patients would primarily work with their doctors on consistent, monitored interventions to tackle the (often lifestyle) issues that are putting their health at risk. Investing in your health should, in my opinion, be taken as seriously as investing in any other asset – and your health is arguably your most important asset. I like to call it “health-wealth”.
I can also attest that, for doctors, the Medicine 3.0 approach is a more fulfilling way of practicing medicine. It’s more deliberate and the results for patients are nothing short of transformative.
This is why my colleague Martin Lebos and I founded Infinity Medical Concierge, as a way to test out this idea of reimagining medicine. We focus on preventive, holistic healthcare, where doctors have access to all screenings, tests and medical records, rather than working in “silos”.
The results have been promising. By developing tailored, proactive plans for each patient based on their profile and risk, we have, in some cases, been able to limit the need for chronic medications and interventions. Unsurprisingly, there are knock-on benefits for mental and emotional health as well.
It’s time to make the shift from reactive to truly proactive medicine that could reward patients with more time to live productive, happy and healthy lives. Ultimately, that’s supposed to be the goal of medicine, and it’s time we moved more decisively towards that goal.
- Dr David Adler is well known in South Africa’s medical fraternity and practises as a specialist physician at Mediclinic Sandton. His experience spans more than 25 years in general medicine. He is the co-founder and director of Infinity Medical Concierge.
At the heart of the digital transformation of South Africa’s healthcare sector is the drive to improve the safety and care of patients. The world is moving towards the vision of ‘Smart Hospitals’ where even the hospital bed can serve as a data-collection and analysing device that monitors a patient’s well-being in real-time and creates alerts in anticipation of a patient requiring assistance.
In the current healthcare environment, patients will encounter many care touch points, with data being created at each point along this journey. Health-related data is amongst the most private and sensitive of datasets, and there are a host of legacy regulations governing how healthcare data may be collected, stored, and secured, as well as how it can or cannot be shared.
Gideon Gersbach, Interoperability Manager at Mediclinic Southern Africa says, “We’re at an exciting time where the scope for digitally driven solutions and enhancements in the healthcare sector is limitless. Data is foundational to all these potential transformations, and so the challenges for healthcare’s tech teams are to find ways to seamlessly integrate disparate and fragmented information systems. When we speak of interoperability, we are working towards a fully integrated system that enables information to be shared securely so that every healthcare professional encountering a patient immediately has access to a complete view of their health records, enabling better care and better outcomes.”
Mediclinic Southern Africa embarked on its interoperability and integration platform project more than two years ago, and it will be an ongoing effort for the foreseeable future.
Gersbach says, “Our Integration platform is a highly available solution, versatile, fast, and high performing. This is to cater for the volume of transactions within Mediclinic’s extensive environment. It allows us to easily create new data integrations, orchestrate processes and seamlessly connect to various sources whilst ensuring specific standards and protocols are adhered to. As messaging between systems is crucial; having a platform that is intuitive, provides guaranteed message delivery, is auditable and fully traceable throughout is invaluable, and all this without compromising on performance.”
