The end of medicine as we know it - and why your health has a future

Medicine itself is sick. We hardly understand any disease and therefore need to chronically treat symptoms but not the causes. Consequently, drugs and other therapies help only very few patients; yet we are pumping more and more money into our healthcare system without any added value.Thus, the internationally renowned physician researcher, Harald Schmidt, predicts the end of medicine as we know it. On a positive note, digitization will radically change healthcare and lead to one of the greatest socioeconomic revolutions of mankind. He is one of the pioneers of "systems medicine", a complete redefinition of what we actually call a "disease", how we organize medicine and how we use Big Data to heal rather than treat, to prevent rather than cure. In this book the author first proves the deep crisis of medicine, but describes how medicine will become more precise, more uniform, safer and, surprisingly, also more affordable. Making a diagnosis will be taken over by artificial intelligence. Current, mainly organ-based medical specialists, disciplines and hospital departments will disappear. Physicians will become patient coaches working in interdisciplinary teams with pharmacists, physiotherapists, nutritionists, etc. and relieved of their workload. Illnesses, including cancer, will be prevented or cured in a precise manner. We will become 100 years and older. Health care spending will shift from chronic treatment of diseases to prevention and health maintenance, thereby dramatically reducing overall costs. Health will become a common good. But Harald Schmidt also warns that those who are not open to digitization will not benefit from these advances and will be left behind. Anyone who wants to benefit from the revolution of medicine must have a digital twin. Is this futurism? No, each of us can have his or her personal genome sequenced, microbiome analyzed, keep an electronic health record. The future has begun. Schmidt convincingly explains the limitations in the current practice of medicine and the need for big data and a systems approach. Prof. Ferid Murad MD, PhD, Nobel Laureate in Medicine 1998, USA Network Medicine, a new discipline that offers a network-based understanding of the cell and disease, is unavoidable if we wish to translate the advances in genomics into cures. Professor Harald Schmidt, a prominent expert in this space, offers the first coherent treatment of the topic, explaining the potential of a network-based perspective of human disease. Prof. Albert-László Barabási, Northeastern University and Harvard Medical School, Boston, USA Visionary, provocative, and full of insights. Professor Schmidt gives a unique and authoritative perspective to the past, present and future of medical science and clinical practice. And all presented in such an inimitable style. Prof. Robert F.W. Moulds, MBBS PhD FRACP, Former Dean Royal Melbourne Hospital Clinical School, Australia Prologue: Many Questions, No Answers Acknowledgements Contents Part I: Crisis, What Crisis...? 1: Too Late Crisis, What Crisis? We Have a Disease System All Are Satisfied 2: Don’t Rely on Your Prescription The Number Needed to Treat Absolute and Relative Risk New Drugs Mostly Without Any Benefit Pseudo-Innovative “Me Too” Drugs Polypharmacy or Polymedication 3: Chronic Disease? Chronic Sickness Costs Quality of Life Chronic Illness Shortens Life Mortality Is on the Rise More Money? No 4: No Prevention Hardly Real Prevention Check-Ups with the Family Doctor Useless Check-Ups at the Dentist Useless Diabetes and the Sugar Scandal Red Meat Alcohol Vegetables and Fresh Fruit Movement Plus Strength Plus Agility Psyche: Sleep Plus Stress What to Do? 5: Male Plus Low Income = Double Whammy Uneducated = Minus 10 Male = Minus 5 Uneducated + Male = Minus 15 6: False Incentives Universal Health Coverage The Loser Is... Only 1% for Prevention Why Germany Was So Well “Prepared” for COVID-19 Even Dying Isn’t Easy The Surgery Boom USA: The Extreme Case 7: The End of Big Pharma The Costs Explode Hardly Any Innovations Limited Growth and Terminal Decline Big Pharma in Court 8: Research Not for Patients Research Output = Paper Fee for Service Not Reproducible Significant!? The Drawer Effect Quality Defects Withdrawn! COVID-19 Research Predatory Journals, Nonsense Papers, and the Eightfold Publication 9: Organ-Based Medicine Rare Diseases as a Model The Organ Boundaries Are Falling Redefining Autoimmune Diseases Asthma ≠ Asthma 10: Interjection 1: How Healthy Do You Want to Be? Part II: The Medicine of the Future 11: Re-discover the Whole Patient Wave #6 IT Platforms Join in How Big Data Is Helping to Redefine Diseases From Symptom to Cause 12: Research for Patients A New Way to Research A New Way to Publish 13: Know your Genes Why Is your DNA So Unique? The Genetic Diagnostics Act DNA Genealogy Your Personal Genome Personal “Omes” 14: Outnumbered Excessive Hygiene Your Gut Microbiome Prebiotics and Probiotics Stool Transplant Does the Wrong Gut Flora Make you Fat? The Gut-Heart and Gut-Brain Axis, Respectively Postbiotics, the Real Future? 15: Your Exposome What Is your Exposome? How to Measure your Exposome? Exposome in Practice The Exposome Economy From Exposome to Prevention Your Data Financial Incentives 16: Big Data Medicine How Does Machine Learning Work? Trendsetters Radiology and Oncology Machine Learning Pervades all of Medicine Apple Watch and Smartphone Machine Learning Overcomes Wealth Gap The New Doctor-Patient Relationship Algorithms Make Mistakes, So Do Doctors Where Are the Hurdles? 17: Healed How to Cure Complex Diseases The Special Case of Monogenic, Rare Diseases Principles of Gene Therapy Substituting the Gene Product, the Protein Gene Therapy Stage 1, outside the Body Whole-Body Gene Therapy Germline Gene Therapy? Live Forever? 18: Well-Tech New Health Companies Health beyond Medicine Well-being by Well-Tech Beware Self-Optimization A New Health System Quality Instead of Quantity 19: Interjection 2: Superhumans Part III: The Future Has Begun... 20: Self-Diagnosis 21: Self-Therapy Nudging Apps on Prescription 22: Your Digital Twin Drug Safety Patients like us Epilogue: Nobody is Sick Anymore Appendix A: Special Page 1 Heart Genetics Appendix B: Special Page 2 Medicine itself is sick. We hardly understand any disease and therefore need to chronically treat symptoms but not the causes. Consequently, drugs and other therapies help only very few patients; yet we are pumping more and more money into our healthcare system without any added value and neglect prevention. Thus, the internationally renowned physician scientist, Harald H.H.W. Schmidt, MD, PhD, PharmD, professor at Maastricht University, predicts the end of medicine as we know it. On a positive note, digitization will radically change healthcare and lead to one of the greatest socioeconomic revolutions of mankind. He is one of the pioneers of "systems medicine", a complete redefinition of what we call a "disease", how we organize medicine and how we use Big Data to heal rather than treat, and to prevent rather than cure. In this book the author first proves the deep crisis of medicine, and then also describes how medicine will become more precise, more preventive, safer and, surprisingly, more affordable