Trends for 2012

By Maria Perno Goldie, RDH, MS
In with the new, out with the old! Happy 2012 to all. As we celebrate our one-year anniversary of RDH eVillage FOCUS, I want to thank all those that have worked to make this newsletter a success: Mark Hartley, Craig Dickson, Duane DaPron, and all the authors who have so willingly given their time and expertise to the newsletter. I want to reflect on 2011 but most importantly, prepare for 2012.

Photo Credit: Jonas Bergstrand
Globalization of medical and dental care and practice will become a progressively more prevailing way to meet these needs. Medical tourism has always been a niche option for a fortunate or not-so-fortunate few. It seems to be for more daring types; however, it is becoming a typical option for anyone with a passport.

Patients Beyond Borders puts the growth of worldwide medical tourism at 25 percent to 35 percent a year.(3) Thanks to the Internet, many people have the resources to research destinations and medical specialties.(4) The costs of procedures and reputations of physicians in places like India, Brazil and Singapore, and Hungary for dentistry, Thailand for elective surgery, and Turkey for ophthalmology are easily accessed.(5)

The accreditation and certification services of the Joint Commission International help remove some of the doubts that medical tourists might have about the quality and safety of healthcare abroad.(6) While patients look overseas or out of the country for treatment, healthcare providers look abroad to bring back people and ideas to improve efficiency and effectiveness. The American Dental Association (ADA) has a “Statement of the ADA Council on Ethics, Bylaws and Judicial Affairs on Dental Tourism - Ethical Obligations of Dentists.”(7) The ADA also has information for patients and dentists on this topic.(8)Indian cardiac surgeon Devi Shetty has pioneered a new model of high-throughput “medical cities” in India.(9) He is currently advising authorities abroad on providing higher quality, more affordable hospital treatments by establishing large specialist centers.(10) Now that interactive technologies are fast and stable, local healthcare specialists are increasingly tapping into telemedicine, linking distance to match medical need to medical resources in order to improve access and/or quality and/or cost effectiveness.(11) It’s the stay-at-home version of medical tourism and it offers three benefits: store-and-forward (sending scans and tests for analysis); remote monitoring (keeping track of chronic conditions through sensors); and real-time interaction through teleconsultations.(12) Consumers’ rising expectations of healthcare preceded the introduction of the Internet, but having Internet access has formed different expectations in medical care. Physicians around the world report patients coming to appointments with medical and pharmaceutical information they’ve found online. MedinePlus, the National Library of Medicine, MedicineNet, Drugs.com, and the Mayo Clinic are but a few of the vast array of resources available to the public and to professionals. The advantage is that patients can have a better understanding of their condition and how to treat it; the downside is the potential for cyberchondria.(13) Cyberchondria (or cyberchondriasis) refers to the unfounded escalation of concerns about common symptomology based on review of search results and literature online.(14) Sometimes learning about diseases tends to lead people to think the worst, similar to medical student syndrome or hypochondriasis.(15) The average consumer does not have the education to interpret the vast amounts of medical information available online, and may worry or be tested unnecessarily. The other extreme is the consumer who self-diagnoses and/or self-medicates without consulting a physician, or not following the advice of their physician. Ahead-of-the-curve consumers, or prosumers, follow healthcare developments closely and have above-average understanding of them. A prosumer in healthcare is a blended word formed by contracting either the word professional with the word consumer. Prosumers look for benefits to come from rapid advances in genetics since the first working draft of the DNA sequence of the human genome was published in 2000. In the business world, the term “prosumer” has transformed from meaning “professional consumer” to meaning “product and brand advocate.”(16)Another increasing trend is personalized medicine, or understanding how an individual’s genes affect his or her response to medications. This will lead to new, more targeted drugs, more accurate dosing of drugs, and improved healthcare safety and outcomes. In the United States, the University of Pittsburgh Medical Center has announced a $294 million investment in a center that will focus on personalized medicine and the biology of cancer and aging.(17) France is already operating a system to identify cancer patients whose genetics indicate if and they will benefit from (nationally paid-for) specific treatments; targeted drugs now account for 57 percent of France’s cancer-treatment budget.(18) We seem to be making progress in the fields of cancer and other genetically linked diseases; however, the most imminent global danger is overweight, obesity, and its mortality and morbidity. In particular, health authorities are very concerned about the rapidly increasing incidence and prevalence of diabetes. Read the sections on Healthy People 2020 News You Can Use and Diet Strategies for 2012 in this newsletter. The U.S. Centers for Disease Control and Prevention estimated this year that 26 million Americans have diabetes and an estimated 79 million U.S. adults have prediabetes.(19) The U.K. has seen a 50 percent increase in diabetes in the past five years, costing the National Health Service nearly a tenth of its total budget in treatment and threatening to bankrupt the service if the current trend continues.(20,21) Globally, the trend is ever upward, with an estimated 366 million sufferers in 2011, including 50 million in India alone.(22)