Stephen L. DeFelice, M.D.
Health care costs are accelerating, the 75 million baby boomers are coming, and no solution is in sight! Doctornauts could be a significant part of the answer of this critical national dilemma. The passage of the Doctornaut Act as proposed by FIM (visitóDoctornaut Act Proposal on the FIM website), is a wonderful, simple and straight forward opportunity to reduce such costs. Though the concept is not complicated, the dynamics behind the rational of the proposal require education on a national level. This is best achieved by holding a Congressional hearing.
A doctornaut is a physician who has the right to volunteer for clinical research with substantially fewer restraints than non-physician volunteers, take greater risks and wave the right to sue. Current technology alone, not to mention future technological advances, offers a cornucopia of potential medical remedies that may either cure or prevent disease — if they can be clinically tested! And this is where the problem is. Formidable barriers, costs and risks, continue to block clinical studies of many potential medical breakthroughs.
And this is exactly where the value of establishing a category of doctornauts comes in; more therapies can be clinically evaluated, accelerating the medical discovery of low cost remedies.
Many believe that doctornauts will lead to the discovery of high cost therapies. Not true! One reason we have high costs therapies is due to the high cost to discover and develop them. The later is exemplified in the sudden drop of FDA approved drugs in 2005 and the recent attempt by FDA to lower the barriers to early clinical research by permitting the administration of very small, non- therapeutic doses of drugs to determine whether they are absorbed and also arrive at their proper targets in the body. The later is indeed a step in the right direction but falls far, far short of what is needed.
Doctornauts will lead to the rapid discovery of both high and low cost therapies which will compete with themselves in the health care marketplace leading to a much desired goal and a reduction of the prevalence of disease and its destructive consequences as well as health care costs!.
Let’s examine a potential low-cost therapy: There are more or less 14 million diagnosed diabetics in the United States that account for approximately 135 billion dollars of annual health care costs. One huge problem related to the devastating complications of diabetes is due to the blockage of very small vessels which carry oxygenated blood to body cells, robbing the latter of much needed oxygen. There is good reason to believe that a low-cost nutraceutical (dietary supplements) combined with a low-cost standard pharmaceutical will make these cells function more normally, even when they are deprived of normal amounts of oxygen.
Let’s assume that this medical approach results in lower costs of thirty per cent. The annual savings would approximately 40 billion dollars, a substantial amount for only one disease! If this could be repeated with the other major diseases such as cardiovascular, mental and malignant tumors, the reduction of total health care costs would be enormous.
On the other hand, it is fair to wonder whether the opposite would occur. Yes, the short term costs would be reduced but this may lead to a longer life span. In this situation the basic costs of diabetic care would not only continue but these patients would be assaulted by other disease such as AlzheimerÃs nullifying the original cost reduction.
The answer to this argument is that during the initial phase of cost reduction, cures and other low-cost therapies will be discovered for these diseases which will undoubtedly be discovered with the help of doctornauts.
The truth is that we cannot precisely know what impact doctornauts will have on health care costs for future events will color the outcome. I am reminded of the great Pericles. When the Spartans were approaching Athens, a walled city by the water, he summoned the cityÃs citizens to the main square to announce his war strategy. All of Athenians would remain in the barricaded, walled city until the Spartans tired and returned back home.
One of the anxious citizens asked, “Pericles, Pericles, are you sure your strategy will work?” Pericles paused and replied, “How the heck do I know? What I do know is that we must do something ñ soon!”
So also, we must do something to reduce health care costs as well as help patients-soon. And doctornauts should rate high on the list.