The healing code

INDIA has the potential to be in the forefront of personalised medicine. The functional medicine would focus on preventative care and before prescribing any medication, the doctor would act as a principle investigator for the patient. For example, the patient's genome would be sequenced, a stool sample would be taken to analyse microbiome, family history would be assessed to evaluate potential diseases and a sample meal would be given to see how the patient metabolises different macro nutrient ratios. 

Lifestyle, diet and socioeconomic status will be assessed to identify key physiological and psychological stressors/limitations. If possible, sleep data should also be taken to understand the patient's quality of rest and circadian rhythm. This differs from the reactionary, symptomatic approach of allopathy practitioners. For one patient a disease may stem from a familial autoimmune disorder, while for another it could be due to environmental factors. By identifying these differences, the doctor can prescribe medication that avoids unwanted side effects. 

Prescriptions can range from lifestyle changes such as yoga, psychological training such as cognitive behavioural therapy and diet changes like introduction of probiotic rich foods. This skill of thoroughly investigating every potential genotype and solving the health puzzle at the origin is the future of medicine. 

As scientists and doctors do this with all their patients, real population data can be run through a machine-learning algorithm. As mandated by NMC, per patient cost calculation would be done by programmes designed by health economists to ensure that there is no referral cut system and treatment cost reduction directly passing the benefit to patients. 

The 1.5 lakh centres planned to be opened by the Indian government's proposed budget under national health protection plan could include such ‘n of 1 trial’ (a single subject clinical trial) described above, converting India into a magnet of healthcare tourism, surpassing TCM (Traditional Chinese Medicine). 

This change will also have a profound effect on science and research. With the creation of the new physical exam, lab researchers and data, scientists can research relationships between patient health and the physical substrates obtained from testing. An example of this is miRNA's ability to alleviate neurodegeneration post stroke. 

Additionally, scientists can parcel out the diamonds within India's vast herbal and Ayurvedic history, an example being turmeric's powerful anti-inflammatory effects or meditation and yoga's ability to alleviate stress and addiction. The scientific culture will shift towards the pragmatic advancement of patient health and happiness over the recognition of any award or publication.

This unique combination of the past and future synergised by the teamwork of India's finest doctors, engineers, economists, and scientists, will allow India's healthcare to become the forefront of personalised medicine.

— Dr Miranpuri is a senior scientist and Singh is a research scholar at SMPH, University of Wisconsin-Madison, USA