Harm reduction 4: The new science of Precision Medicine

Precision medicine, functional medicine, person-centric medicine, person-centered medicine are all new terms in clinical medicine practice today. They focus on treating the patient as a whole and not just the disease alone.

A classical modern medicine doctor would ask “What is my patient suffering from?” but the functional medicine doctor would ask “Who is my patient?”

For any treatment, we can have either a people-centric approach or a person-centric approach.

Most guidelines are public-centric. A classical example is community reduction of salt to reduce the incidence of hypertension. This approach will reduce salt intake of even those people who may not require it as many of them will be salt resistant.

People-centric medicine takes into account evidence-based medicine as the main evidence, which may not be 100% correct as it deals with the group/s and not the individual. It also takes into consideration the patients in the curve ignoring those outside the curve; the individual patient you are treating may be outside the curve.

Remember for a child who has failed an exam, the results of the school are 0% even if the school success rate may be 99%.

The main aspects of person-centered medicine are

  1. Social determinants of health including mental and financial health
  2. Hope, faith and beliefs
  3. Free will and individual choices

For example, tobacco kills, is a well-known fact but an individual who wants to quit may like to shift to less harmful tobacco or nicotine-based alternatives.

Harm reduction is well described in the Vedic literature. In Jainism, there are two terms Anu-Vrata (fast) and Maha-Vrata.

In Maha-Vrata, the vows and restrictions are to be observed 100%, but in anu-vrata one observes restrictions that are as much as possible.

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