The latest buzz word in health care is to make it ‘personalised’. This word I have noticed is used interchangeably with ‘precision’ medicine. Precision medicine is where drugs are ideally chosen to be used dependent on the genetic profile of each person. But this is hardly personalised! It may be precise, but it is definitely not the definition of personal.
When I consider the term ‘personal’, I consider the person and what it is to be a person.
There is far more to our make up as people than our genetic makeup! We are whole people with feelings, thoughts, sensitivities, dreams, aspirations, relationships, jobs, families, children and a whole host of assorted issues and personalities. There is far more to being a person than our genetics, our gender, and our anatomic arrangements!
Making something personal, means that we are cared for as a whole, that our uniqueness is taken into consideration, and that treatments are tailored for us as a person. As a whole person, not just a set of genes, organs and blood tests.
The notion of personalised means that things become exactly that. Personal. Where you connect with and develop a relationship with your doctor or other health care provider. Where you and your practitioner are seen and respected for the people that you are.
I agree that medicine needs to be personalised, and as precise as possible, but I feel that the two of these things are quite different. Improved precision will come automatically when our relationships in medicine are in fact personalised.
Sadly, Medicine in many cases has become impersonal, uncaring, and utilitarian, focussed on outcomes and function rather than people. Much of medicine is referred to as bulk billing ‘assembly line medicine’ where the focus in engagements and consultations is on defining ‘the problem’ as quickly as possible for maximum financial return rather than connecting with and understanding the person as a whole.
At our heart we are all caring and feeling human beings, and more than anything else, we crave connection. We crave to be cared for and to be deeply understood.
When we are sick in particular more than anything else this is what we want.
We all know that there is far more to us than the function or dysfunction of our body parts!
Having the most precise choice of drugs will not make our medicine personalised, it will still be impersonal and about best function, and not about people.
Medicine is designed to be personal and to be personalised. Healing comes through the personal interactions and human connection, not just the drugs and procedures.
But how might we do that?
To make medicine personalised and personal, we first need to take care of ourselves and be real. The whole real deal and not just the white coat role of ‘doctor’.
In medicine we are trained to be professional, we are trained to speak in a way that does not reflect the person that we are. We are trained to present ourselves in a different way with our patients than we would ordinarily speak with people.
This is not making things personal, this is creating a professional barrier between ourselves and other people.
Whenever there is barrier, it means things are less personal and thus less personalised.
To build a personalised medicine as doctors I feel that it is important that we bring our own qualities to work, that we be who we are with our patients and let them see who we are.
One does not need to be or wear a professional mask to do all of the things that are needed in medicine.
One does not need to be officious and dictatorial to have an influence on patients or to inform them of the facts and best treatment options.
One simply needs to build relationships and have discussions as people, as who we naturally are, and this is not something that we are trained to do as medicine.
Our innate natures as human beings are to be caring and feeling and sensitive. If we are trained to be ‘professional’ and officious and to create a professional barrier between ourselves and our patients, then we can never deliver a service that is personal or personalised.
No two people are the same, nor ought they be. No two people can deliver the same service in the same way and nor ought they.
As long as we try and make each doctor ‘the same’ then we are going to be getting in the way of truly personalised medicine as each doctor is trying to act in a way that their peers do which may well be different to their own personal way with people.
People are not actually seeking standard cookie cutter doctors. They know that personal makes a big difference. And the person is everything in medicine.
Just like we do with other people and our friends, we all seek out people that we can relate to, that we can trust.
The beauty in medicine is that there are so many different people with different qualities that different people can relate to. And these are the personal qualities that we need to nurture and bring out in our physicians, not the official white coat persona.
We need to be free to express in our own manner with our patients, and not according to an impersonal professional mould.
The professional mould is what makes medicine impersonal. It makes it about ‘doctor’ and ‘patient’ and not two people.
Personalised medicine begins with a personal relationship between each physician and their patients, one that is founded on equality and appreciation of the unique expression of each person.
Personalised medicine begins with a care that develops between two people where the physician takes into consideration and sees people, including themselves, as a whole and not just as a disease set or set of ‘test variables’.
It begins with the care that we have with ourselves as when one cares for oneself that is a quality that is felt in the presence of others in all that is done.
Personalised medicine is about respecting, caring for and seeking to understand each person.
It is about working in partnership with each person, understanding their health care philosophies, rather than seeking to make them conform to what we want and think will be the best health care for them.
When we are able to develop these personal relationships with people, that are caring and enduring then we will have the personalised and truly caring medicine that we are seeking.
Keeping medicine personal and about people is vital to the integrity of medicine.
And not only will it be great for patients, improving patient satisfaction no end, it will be great for us too as medical professionals: free to develop the quality of relationships we naturally are inclined to do so as who we are and not who we think we need to pretend to be.