How advanced is contemporary medicine

Great Debates
1

I was reading about the growth of AI in medical diagnostics, and an article mentions that there are roughly 10,000+ diagnosed medical conditions in humans and how AI would do a much better job of sifting through data for proper diagnosis. Is that a good estimate for the number of things that can go wrong with the human body, about 10,000?

That made me think, contemporary medicine started in the mid 19th century so it is about 160 years old now. How good would people rate it?

I’m assuming a scale from 1-5 could be used to determine how effective medicine is at treating medical conditions. A 5 would be a condition where medicine can (in about 95%+ of cases) either prevent or treat the medical condition entirely. A 4 might be where medicine can usually control symptoms, but not get rid of the underlying condition. A 3 could be a chronic condition that may get better, but may get worse and many interventions help but many do not. A 2 may be something that chronically gets worse and can’t be treated, but medicine can make some inroads. A 1 would be something where modern medicine can do nothing but provide pallative care.

As examples, I’d assume tooth decay would be a 5. Medicine knows how to avoid it for most (but not all, since some people have genetically weak teeth) people. Avoid sugars and acids. Use flouride. If a cavity comes, get it drilled and filled. If that fails, get a root canal. If that fails, get an implant. Get checkups every 6 months to verify that you aren’t getting cavities. For most people that works pretty well to ensure tooth decay is kept at levels that prevent chronic pain or teeth from falling out. I would also assume many (but not all) microbe and parasitic infections are a 5, as well as most forms of malnutrition. Some people still die of infections but in the wealthy world it isn’t 30-50% of people who died from them that occurred 400 years ago. Outside of flu and pneumonia infections aren’t a leading cause of death now in the west.

A 4 may be hypertension. It can be controlled in most people using a wide range of treatments, but not really cured.

A 3 could be knee pain. It could get worse, but if you find all the right treatments and use them together it could get better. But what works on you may not work on someone else.

A 2, maybe a form of cancer medicine isn’t too good at fighting yet (pancreatic as an example)

A 1, maybe aging (aging should be considered a disease) or whatever disease puts you in hospice care.

So for all you medical professionals out there, use the 5 point scale I just pulled out of my ass to describe 160 years of compounding medical advances.

Seeing how there could be 10,000+ diseases, but it seems like it is only ~500 (as a guess) that plague modern, wealthy western society does that mean we’ve figured out most of the others? For example autoimmune disorders, obesity, various musculoskeletal problems, various neurological problems, cardiovascular and endocrine disorders, etc still exist and are everpresent. But chronic diseases make up about 75% of health care spending. I don’t know what that list would include (I believe there are over 200 forms of cancer alone) but looking online it is usually a few dozen that get mentioned over and over. It seems like we’ve reached a point where a few hundred diseases and conditions cause the vast majority (but not all) of our illnesses, disability and death. Is that accurate?

2

My opinion is that aging is the root cause of most of the problems people die from in the western world. Diabetes, hypertension, obesity, hyperlipemia, and genetic predisposition raise our risk of things like heart attack and stroke. However, a 30 year old with all 5 of these is still at a much lower risk of death in the next 20 years than a 100 year old with optimal lifestyle and good genes. The reason for this is that aging is what kills most people in the western world, not these other conditions. I will go so far as to say that other than cancer and genetic or congenital disease, the vast majority of things that kill us are due to old age. I also don’t see why we shouldn’t be able to cure aging as our knowledge of genetics advances. My guess is that a cure for aging will be developed some time in the next 200 years, hopefully much sooner than that.

3

yes but not everything is the same. Millions of people used to die of smallpox now no one does. I’d say that is a much bigger deal than not being able to cure high blood pressure. Lots of things used to kill a lot of people no longer do so that now they live long enough to get chronic conditions. Everyone that died of childhood diseses in the past didn’t get a chance to grow up to get adult problems, now they do. I think modern medicine is very advanced.
Also think FlikTheBlue said it very well.

4

Modern medicine is miraculously advanced! Open heart surgery, liver transplants, a pharmaceutical compendium you couldn’t fit in a warehouse, sewing people’s severed fingers back on and reconnecting the nerves…

I could gush!

5

I agree, you fix aging and you fix most problems. Not all though, you still have neurological problems (mental illness, etc), musculoskeletal problems and autoimmune disorders. But if you could keep people at age 25 their whole lives people wouldn’t get very sick.

Cancer is a disease of aging too. http://www.atsdr.cdc.gov/risk/cancer/images/cancer_by-age.png

6

I suspect if you measured from the standpoint of 150 years ago everything would be a 5.
What percentage of early deaths are due to things we do to ourselves - smoking, pollution, weight, alcohol. And I don’t think aging is a disease - aging is a feature which removes the old from the population, since we don’t have predators to do it for us.

The main differences are better tools, procedures, and understanding. My father, at age 45, spend months in the hospital with a blood clot. They couldn’t do anything really except give him blood thinner and hope it dissolved. My father, age 90, had another one. They put in a double stent through his leg, and he was out of the hospital in 2 days.
If you are looking at medicine from the perspective of Star Trek, then we are a lot lower.

7

How many diseases cause most of modern illness depends on whether or not you are a splitter or a lumper.

A lumper says “neoplasm” or “cardiovascular.” A splitter can make thousands of diseases out of those.

As a rule of thumb, modern medicine has become increasingly effective and increasingly dangerous from a couple hundred years ago when medicine was generally ineffective but not that dangerous (except for the bloodlettings). Today we can wipe out your entire hematopoietic system and give you someone else’s stem cells. If you don’t die, it might even cure you.

However most of the improvement in modern health compared with 200 years ago comes not from curing disease but from preventing it.

Public sanitation, vaccination, better nutrition, diminished hard labor, better living conditions…all these and more are the main reason we live longer and better.

The big current scourges fall generally within the families of obesity, cardiovascular disease and neoplasms. Get rid of smoking, overeating and watching TV and we’d probably be halfway there to getting rid of the attendant plagues from those big three (diabetes; hypertension; lung and other adenoca’s; a lot of arterial disease…).

If you just want to know how advanced medicine is, the answer is that it’s quite amazing. Joint and organ replacement come to mind, as do the advances in minimally invasive surgeries–not to mention really cool things like hypothermic anesthesia for complicated surgical procedures and so on. The next big things are stuff like DNA-tailored therapies or even altering DNA. The list goes on.

But we haven’t made many advancements getting the fatties off the couch and there are way more of them than there are people needing fancy therapies.