Medical Doctors (MDs) in academia & industry


How is this group defined?


Medical doctors (MDs) are almost synonymous with applied medicine.They represent the front line treating patients, deciding on treatment strategies and patient care. There are several categories of MDs listed here in descending order with respect to patient contact. First of all there are the practitioners, MDs working in medical practices and surgeries across the country. The often fulfil a role as family doctor and are usually the first MDs to whom patients turn upon any new health concern. The second group is defined by the many MDs working in hospitals where more sophisticated high-tech medicine is available for conditions beyond the means of a standard medical practice. Surgeons are a prominent part of this group of MDs. The third group of MDs sees patients only occasionally as this group is working in research, especially in pharma research. They are more tasked with the development and improvement of new forms of drugs than with direct patient care. And last, not least, there is an army of MDs working in agencies, health care providers, legal departments, parliamentary committees and other institutions that do not see patients at all but provide the required expertise for medical regulations, drug safety rules and procedures, etc. This is the group setting the stage and the boundaries within which all the patient-caring MDs have to work. 


What are the major roles of this group in personalized medicine?


If anybody sees the impact of personalised treatment first hand then it’s the MDs. They not only provide the first expert feedback about any personalized treatment (if allowed to do so by their patients). They are the ones deciding whether a patient gets a personalised treatment or not in the first place. 


Fig 25: Medical doctors (MDs) are the central hub of medicine 


What is the major impact of this group on the development of personalized medicine? 


Personalised medicine is based on genetic traits of the patient and uses all kinds of measurable parameters to decide on the best treatment and judge treatment results. However, a human being is far too complex to be reduced to measurable parameters, regardless how many are measured. In the end the complete picture needs to be seen and taken into account when drawing conclusions about the success or failure of a treatment. This its exactly what MDs bring to the table. Their experienced and expertise in seeing beyond mere measurements is a huge advantage. However, being humans as the rest of us, they also fall prey to prejudice, errors, and misjudgements. I believe that by and large the positive impact of MDs outweighs whatever the imperfect human nature may take away from it. Neither “objective” measures nor experts are infallible, which we should never forget when coming across controversial results or opinions. 


With whom has this group the most important interactions?


Patients come to mind first, of course. However, MDs spend a lot more time than they like dealing with heath care providers too get reimbursed for decisions they made. They need to keep up with the latest developments spending precious time on their own education, taking away time from patients. However, most current MDs have not been exposed to personalised medicine during their studies as the topic is rather recent. Therefore, education is their only chance to catch up. MDs must know the legal rules they have to play by, they also must and do consider ethical aspects seriously and their feedback is crucial for new research. MDs are the central hub of medicine and personalised medicine is no exception.


What is required of this group to further the development and application of personalized medicine?


Keeping abreast with the development of new drugs and treatment schemes based on the novel concept of patient genetics requires jumping over their own shadow for MDs. It costs time (MDs are always short on time) eventually requires to venture outside their familiar area of expertise. It also brings new challenges since the genetic and molecular measures cannot be directly interpreted like a clinical symptom. Yet without the engagement of numerous MDs, personalized medicine will never reach the majority of patients. 



What’s coming up next?


Next week we will look briefly into he role of medical laboratories, the places where most of the measurements and tests are carried out.

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