In last month’s blog I announced my retirement from clinical medicine and opined on the more negative changes in health and healthcare I’ve seen in the last 35 years. In this month’s blog I will touch upon the positive things that have come along—things that I have observed personally and also have read about or heard discussed at conferences, in the medical literature and in the press.

1. Americans are smoking cigarettes a lot less that in the 1960’s. According to the Centers for Disease Control & Prevention, a mere 14% of Americans smoked in 2017, an impressive 67% lower smoking incidence than in the 1960’s. That is huge. Reflected in that is the vast decrease in cardiovascular disease deaths during that time. Death from stroke, a major risk of smoking, has decreased 75% over that same time frame. Now, if only we could get a handle on the obesity epidemic, then we really will have accomplished much!

2. Life expectancy for Americans increased 6.6 years between 1970 and 2005. Since 2005, the numbers have even gotten better. Again, less smoking has a lot to do with this, but better diagnosis and treatment of cardiovascular disease has contributed as well. (But, don’t think that that is final. Obesity and overweight rates of over 70% still threaten to undo or mitigate some of those advances.)

3. New therapies, like gene therapy and stem cell therapy, show promise for diseases as diverse as sickle cell anemia, Parkinson’s, ALS, cancer, autoimmune disease, heart disease, type 1 diabetes and others. Gene therapy involves the introduction or genetic material into a target cell to replace or block a protein that causes a disease state. Stem cell therapy, controversial in its own right (see my prior blog on this) still has shown promise, when developed and employed by legitimate university-based or NIH-affiliated research centers. It is a complicated topic to discuss scientifically, but one could easily learn the basics behind this multi-faceted therapy by reading on the web. 

4. Genetic testing has saved and improved lives. Tests exist now that were not available decades ago. Bipolar disease, certain cancers, Parkinson’s, celiac disease, Tay-Sachs disease, cystic fibrosis and many neurologic diseases, as well as others, are amenable to genetic testing. Early diagnosis and treatment have been the keys to helping so many people who were victims to fate before this technology came along.

5. Telemedicine is something that really was only a dream decades ago. Now, people who don’t have easy access to care, and even patients in busy urban areas who can’t get an appointment with their doctors, are still able to get the attention they need to address many medical issues that need follow-up. And this trend appears only to be growing. There are still kinks in the system, but overall this has been a plus.

6. Medical care delivery by physician’s assistants and nurse practitioners are a growing trend, and that has taken a large burden off the delivery of health care for many straight-forward issues. And the training and expertise of these professionals appear only to be on the upswing. 

7. The internet can be a boon for research into medical problems and where to get care for the discerning consumer. But beware the “Dr. Google” syndrome, and don’t try to diagnose yourself. Seek professional help before you draw conclusions.

8. The CAT scan and the MRI! What did we ever do without them?

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