Medicine has changed so much over the past years,   I look back even to when I finished my program and in the mere 20 years since I finished, medicine has changed dramatically.  I can remember when I was a student, seeing a patient with rheumatoid arthritis and advising her that the best treatment we could give her was a DMARD.  Now we have multiple monoclonal antibodies that not only work well, but they prevent the joint damage which is so debilitating to the patient.

Twenty years ago when I started working at an internationally known cancer center we were just beginning to use 2-CdA for hairy cell leukemia and chronic lymphocytic leukemia.  But there wasn’t a cure for CLL, now we sit on the precipice of a possible cure for this very disease, by using gene insertion into the patient’s T cells, which is the research that was just released from the University of Pennsylvania.

But if I look back just a little bit further, back to the 1940s and early 1950s medicine has changed even more dramatically, from barely having two antibiotics (penicillin and sulfa) to a whole cauldron of available antibiotics to use against very specific microbes.  Vaccines were just beginning to be produced and used in public health in the 1950s with the advent of the first polio vaccine.  Now we have vaccines against a myriad of diseases, to the point that many of the pediatricians these days haven’t even seen a measles rash, which used to be so common back in my days of attending elementary school.

Medicine has changed so much even over the past 60 years, that what used to be a cause of death (infectious diseases) is no longer.  Now with the advances in oncology, even cancer is becoming more of a chronic disease, than the killer that it used to be.   Deaths from heart disease, albeit not as bad as they used to be, still have room for improvement.

Seeing the almost log rhythmic increase in medical knowledge, even over the last 20 years, which results in new clinical applications of treatment for patients, it makes me dizzy to even try to think of the amount of clinical knowledge and treatment modalities that we will be dealing with in the near future.  Medicine is definitely on the precipice of some amazing and wonderful advancements.

Now the question becomes, how do we get our patients to understand their part of the picture?  How they need to change their lifestyles, start to exercise, address their obesity issues.  Patients have a part to play in their own medical care.  And I believe motivation is the key.  We as clinicians, need to find that magical key with each one of our patients, turn it on, and then help our patients keep it turned on.

Sharon Bahrych is a physician assistant who blogs at A PA View on Medicine.

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