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                                斯坦福专家:不要只盯着精准用药,更要提倡精?#23478;?#30103;

                                柳仕鲁(Andrew Nusca) 2019年04月09日

                                斯坦福大学医学院院长希望人们少谈一些精准用药,多谈谈“精?#23478;?#30103;”。

                                斯坦福大学医学院院长劳埃德·迈纳希望人们少谈一些精准用药,多谈谈“精?#23478;?#30103;”。

                                当然了,精准用药是真正患病时需要的对策。如果确诊患癌,精准用药就意味着,配合具体病症和个人的基因对症下药。

                                精?#23478;?#30103;则是硬币的另一面。“目标是精准地预测、预防和治疗。”迈纳在上周三出席于加州圣迭戈举行的《财富》头脑风暴健康大会时这样解释。

                                科?#34892;?#20869;科医生迈纳表示,随着精?#23478;?#30103;的发展壮大,对极其具体的精准用药治疗需求已经减少。他说,在心理疾病问题?#24076;?#31934;?#23478;?#30103;也能打开局面。

                                “我们对心理疾病相关医学的了解还处于初期。”迈纳称,“可是,科研进展的速度令?#26031;?#33310;,现在医学上已经不再将抑郁视为单一疾病。”

                                抑郁可能需要分一些亚型,和癌症比较类似。心理疾病之间的差别显然很大。迈纳认为,更全面分类可以帮助医学专业人士“不局限于症状的表象,更透彻地研究,哪种治疗方法可能最?#34892;А!?/p>

                                他说,预测和预防心理疾病“是我认为正不断取得进展的领域”。?#20197;?#30340;是,用人单位已经开始更重视员工的心理健康状况,“注重提升职场的心理健康和幸福感。”

                                不过,还有很多工作需要做,尤其是地方医院层面。迈纳指出:“在美国,超过一半执?#30340;?#31185;医生忙得精疲力尽,这种现象不可?#37038;堋!?/p>

                                迈纳认为,部分原因是电子病历。内科医生在电子病历系统上花费的时间和给病人看病的一样,甚至更多。“我觉得,投身医学可不是为了当处理电子病历的专家。”他说。

                                迈纳称,影响人体健康的各项因素之中,医疗保健和基因占了四分之一。社会、行为和环境方面的决定因素占了剩下四分之三。这就是我们需要更多精?#23478;?#30103;,以及可能要多休息的原因。

                                迈纳指出:“打造整个社会的健康观至关重要。?#20445;?#36130;富中文网)

                                译者:冯丰

                                审校?#21512;?#26519;

                                Lloyd Minor, dean of the Stanford University School of Medicine, wants to hear a little less chatter about precision medicine and a little more about “precision health.”

                                Precision medicine, of course, is the solution for when you’re really sick. Diagnosed with cancer? Precision medicine suggests a treatment that caters to your specific disease and your genetic makeup.

                                Precision health, meanwhile, is the flip side of that coin. “To predict, prevent, and cure precisely,” Minor said last Wednesday at Fortune’s Brainstorm Health conference in San Diego.

                                The need for ultra-specific precision medicine treatments is reduced with growth of precision health, argued the academic-physician. Consider mental illness—precision health could make a difference, he said.

                                “Our knowledge of the science behind mental illness is still in its infancy,” Minor said. “But the pace of scientific advances is encouraging. We’re moving beyond thinking of depression as one illness.”

                                Depression may require subtypes, not unlike cancer. And it’s clear that mental illnesses vary considerably. Thus a more holistic approach would allow medical professionals to “look beyond, or in addition to, the symptoms at what the most effective treatment may be,” Minor said.

                                Predicting and preventing mental illness “is an area where I believe we’re making some progress,” he added. Thankfully, employers are already beginning to focus more on mental health and wellbeing of employees to “make mental health and wellbeing a feature of the workplace.”

                                But there’s more work to be done—especially at your local hospital. “Over half the physicians practicing medicine in the United States are burned out,” Minor said. “That’s just unacceptable.”

                                Electronic health records are partly to blame, he said. Physicians are spending as much, if not more, time in front of EHRs as patients. “I don’t think any of us went into medicine because we wanted to be an expert in making an EHR work,” he said.

                                Medical care and genetics make up about one quarter of the total inputs for a person’s health, Minor said. Social, behavioral, and environmental determinants dictate the rest. Which is why the world needs more precision health—and perhaps a little more rest.

                                Said Minor: “The culture of wellness within our organizations is so critically important.”

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