pointer to David Healy’s lecture, “The Future of Medical Care: Can Industrialized and Marketized Healthcare be Made Universally Available?” I enjoyed this very much. He places the notion of “caring” and “doing no harm” as a top priority in medicine (his focus is largely on psychiatric care) and then lays out a way for this old fashioned value to fit within the large-scale science-driven, evidence-based healthcare system of today (mainly by adequately considering the side-effects of medication treatment). Dr. Healy is well known for taking the pharma industry to task for selective-presentation of data, ghost-writing and other aspects of profiteering behavior – and does not disappoint here.
As a personal observation, I often hear psychiatrists and researchers say that, “Schizophrenia is (someday will be classified into) 10 separate disorders” – which, after listening to Dr. Healy’s lecture, seems like code for, “if we increase the complexity of the diagnostic criteria, we can create more separate avenues for treatment”, which seems like code for, “we can pull in more revenue“. Perhaps systems neuroscience (perhaps even genetics?) will reveal that there are many common networks that are disrupted across disorders and might help counteract additional splintering of diagnostic criteria. I don’t know, but certainly an issue worth exploring in more detail.
UPDATE: Here’s an example of common genetic variation that accounts for risk of both Schizophrenia and Bipolar Disorder. The current head of the NIMH says, “These new results recommend a fresh look at our diagnostic categories” Nice to see this!