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12.19.17 Dr. Robert West is a self-described “personalized medicine evangelist.” Currently an associate professor emeritus at SUNY Upstate Medical University, Dr. West has spent much of his recent personal and professional life studying and teaching the importance of personalized medicine. A chronic patient himself, Dr. West battles both chronic asthma and chronic pain and uses his Twitter account to help patients learn about their disease. “A lot of chronic disease patients are ‘exceptions,’ not the ‘rule’,” notes Dr. West. “I’m one of the exceptions, particularly regarding asthma. Traditional treatment options don’t work for me, and that has really inspired me to work on behalf of patients and become an advocate.” This also served as the impetus from which Dr. West began educating medical students to avoid “one size fits all” medicine, beginning with a medical elective in 2009 named Personalized Medicine 101. The Chronic Disease Coalition spoke to Dr. West about personalized medicine and why it’s important for doctors to treat the patient and not the disease. He gave us his top three reasons why:
  1. We’re all genetically different. Many chronic “diseases” are essentially artificial “bins,” and so it’s much more difficult to treat the person because we’re all fundamentally different (except for identical twins). Until the sequencing of the human genome, we couldn’t process information to look for genetic differences. We know that specific genes may cause someone to react differently to a particular medication than someone else.
  2. We have the tools to do so. We have more information now than ever before about an individual’s genetic makeup. With the help of technologies like GWAS (or genome-wide association studies), WGS (whole genome sequencing) and WES (whole exome sequencing), doctors are able to identify genes linked to the disease – giving us a more comprehensive overview and thorough understanding of how we can treat the individual patient. The number of personalized tools available to attack chronic diseases is growing, and we need to begin to match treatments with patients instead of diseases.
  3. It’s cheaper in the long run. By focusing treatment on the patient rather than the broad disease, personalized care is given immediately and is often more effective. A diagnosis comes faster, and doctors are able to work with their patients to develop a unique treatment plan instead of using a generic plan that may not account for variations in their condition. Many patients haven’t found effective treatments for their chronic disease. For example, patients battling rheumatoid arthritis often have difficulty finding a treatment plan that effectively manages their symptoms. If the chronic disease and personalized treatments are quickly identified and effective, that means fewer doctor appointments, less time spent in waiting rooms and in line to refill fewer prescriptions.