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Beyond 7 minutes

I trained as a Family Doctor so that I would be ready to help patients with any challenge. The old school family doc used to take that skill set out into the community on house calls, sports sidelines, and town hall meetings. At some point the job description was boiled down into a job that started and ended with a 7 minute office visit. That setup is not good for patients, and it's not good for doctors. In this column I hope to start to push the boundary of where the doctor patient interaction takes place - onto the page, into the community, and beyond 7 minutes.

Advances in Medicine

The Cost of Cellular Therapies

As a family doctor I try to stay up to date on the most recent research. The most interesting article I have read in some time was in the New Yorker magazine, “The Promise and Price of Cellular Therapies.” It talks about advances in cancer treatment. There is some interesting research going into using the body’s natural immune defense to fight cancer. The research is still in its preliminary stages but could change the way we treat people with cancer.

The article was at the same time inspiring and frustrating. The idea of a medical breakthrough gives hope to people who are burdened with disease. The problem is that these promises are not always borne out.

History shows us that things that we hope will revolutionize medicine are often hard to develop into useful tools. Gene therapy and personal genomic pharmacology are just two examples of medical technology that have promised to change the way we treat disease but as of yet have not delivered on those promises.

Proven Treatments

On the other hand, as a medical system we have a whole range of low-cost proven treatments, which we know save lives, that are not being used to their full potential. These are things like colon cancer screening, smoking cessation programs, blood tests for communicable diseases like HIV and hepatitis C, blood pressure control, as well as vaccinations which prevent diseases.

These are not glamorous new inventions, so they tend not to get the same attention as a new designer drug or scientific discovery. The important thing is that we have robust data to support these as proven interventions that prevent disease. Beyond extending lives, they are relatively inexpensive.

Scientific discovery is important. Without it we would still be treating common maladies with bloodletting and mercury. However, we are neglecting discoveries of years past only for the potential promise of new discoveries that may not even work. If we redirected even part of the money that we spend on research and development to support proven public health interventions, we could help people live longer healthier lives.

One example would be making colon cancer screening free whether you have insurance or not. Another example would be holistic support for smoking cessation not just free gum and a phone number.


The backbone of any of these interventions should be low cost comprehensive primary care to help people control common diseases like diabetes and high blood pressure that we know how to treat. Accessing this type of care is only possible if people can establish care with a primary care doctor they trust. Through these relationships we can help people quit smoking, bring the blood pressure down to a normal range, eat healthier, and feel happier. It may not be glamorous, but at least we know it works.


Siddhartha Mukherjee, Siddhartha. “The Promise and Price of Cellular Therapies.” The New Yorker, July 22, 2019.

This story was also published in the West End News, September 2019