Evolution of Medicine and the Role of the Physician

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Κυρία Κορομηλάς
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1 Evolution of Medicine and the Role of the Physician Harisios Boudoulas, MD, Dr, Dr Hon. Professor, Academician The Ohio State University, USA Biomedical Research Foundation, Academy of Athens, Greece

2 Evolution of Medicine Evolution related to diseases Evolution related to technology science The role of the Physician

3 Evolution Related to Diseases

4 Infectious Diseases 100 Rheumatic fever Syphilis Peptic ulcer Tuberculosis Other 0 Time

7 Diseases Related to Medical Progress (Iatrogenic) 100 Prosthetic valves/valve interventions Post corrective surgery in CHD Intracardiac/intravascular devices (pacemakers, defibrillators, stents, other) Post bypass/pci Transplantations Hemodialysis Immunocompromised patient Valve disease related to drugs Other 0 Time

8 Diseases Related to Increased Life Expectancy 100 Calcific aortic stenosis Mitral regurgitation Aortic aneurysms AV block, arrhythmias Other 0 Time

9 New Diseases 100 AIDS Kawasaki Prion diseases (mad cow disease) Avian (H5N1) flu Swine (H1N1) flu Other 0 Time

10 Metamorphosis of Diseases 100 Certain Infectious Diseases Iatrogenic Diseases Life Expectancy Frequency Atherosclerosis New Diseases 0 Time

11 Evolution Related to Technology - Science

17 Percutaneous Valve Replacement

18 Nanotechnology Molecular Imaging

21 Patients Pharmacogenetics Genetic Analysis No response or side effects Treatment with another drug Good therapeutic result

22 Cell Based Therapy / Biomaterial (Platelet) Intracoronary infusion Direct intramyocardial injection Epicardial (Surgery) Endocardial (Percutaneous) Boudoulas KD et al. Dis Model Mech 2009; 2: Rane AA et al. JACC 2011; 58: Hensch G. JACC 2011: 58; Cheng K. JACC 2012; 59:

23 The Role of the Physician

24 The Role of the Physician Maintain or restore human health (Prevention, diagnosis, treatment of diseases or injuries, relief of suffering) Knowledge Competence to apply the knowledge to the patient Ethics of medicine

25 The Evolution of Medicine and the Physician Molecular Mechanisms, Systems Biology Genetics, Proteomics, Bioinformatics Evolution Imaging Techniques Pathophysiologic Mechanism (cardiac catheterization) Biochemistry Hematology Labs Clinical Picture Pathology Correlation Clinical Observation Time Hippocrates 21st Century

26 Physician Clinical Experience Science/Technology

27 The Master said, He who learns but does not think, is lost. He who thinks but does not learn is in great danger! Confucius Αυτός που µαθαίνει αλλά δε σκέπτεται έχει χαθεί. Αυτός που σκέπτεται αλλά δε µαθαίνει κινδυνεύει! Κοµφούκιος

28 Do not lose contact with the patient. Genetics / Molecular Mechanisms Catheterization Echocardiography Genetics / Molecular Mechanisms Catheterization Echocardiography Others Nuclear Cardiology Others Nuclear Cardiology Stress Tests Stress Tests

29 Ο στρατιωτικος ιατρος, η αντινοµια στη µαχη: Οταν ολοι εξολοθρευουν αυτος αντιστεκεται σωζοντας.

30 Peabody, FW The Care of the Patient the secret of the care of the patient is in caring for the patient.

32 Errare Humanum Est «Τούτον τον ιατρόν ισχυρώς επαινέσουσιν τον σµικρόν αµαρτάνοντα» Ιπποκράτης «Το δις εξαµαρτείν ούκ ανδρός σοφού»

33 The Continuous Evolution of Medicine and the Constant Role of the Physician Continuous changing of diseases The Physician must follow the evolution of medicine Clinical Applications Medical Technology Medical Science In this continuous evolution of medicine the role of the Physician remains constant.

34 The Superior Physician He is skeptical toward the data of his own profession, welcomes discoveries which upset his previous hypothesis, and still animated by human sympathy and understanding. Physician Alfred North Whitehead, Dialoges (Lucien Press) 1954 Clinical Experience Science / Technology Ethics

35 if a doctor s life may not be a divine vocation, then no life is a vocation and nothing is divine Stephen Paget Confessio Media «εάν η ζωή του Ιατρού δεν µπορεί να είναι θεϊκό λειτούργηµα, τότε καµία ζωή δεν είναι λειτούργηµα και τίποτα δεν είναι θεϊκό»

37 Από το Βελβεντό, στη ΣΙΣ, στο ΑΠΘ, στο Ohio State University, στο Ίδρυµα Ιατροβιολογικών Ερευνών Ακαδηµίας Αθηνών

39 Thank you!

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