Personalised medicine and National Health Service culture

I was surprised to read that personalised medicine and healthcare has now become a genetical and pharmacological concept. ¹ There is a much older and more important concept of personalised medicine and healthcare, not least because many patients do not need any medication at all. Nearly all patients greatly value the personal attention of a trusted healthcare worker, medically qualified or otherwise; someone who has the time and communication skills to listen to their varied and sometimes irrational needs, anxieties and beliefs, and is also willing to address the family, psychological and social aspects of their disorder, whether or not they have a physical illness. This personal relationship has a powerful therapeutic effect even if we do not understand the mechanism. It can reduce the need for medication in many clinical situations.

It is a paradox of modern Western scientific medicine that it has been associated with an enormous growth in alternative medicine. This is at least in part due to the personal care provided by alternative practitioners, while at the same time our modern evidence-based scientific medicine has become increasingly multidisciplinary and impersonal. The latter is a contributory factor to the culture problems in the NHS, which have been highlighted by the Francis report. ² One way of addressing this culture is to re-introduce the older and neglected concept of personalised medicine into the NHS, including continuity of care. Individualised medication perhaps, but personalised medicine and healthcare as traditionally understood please.