Despite remarkable scientific and technological achievements during the 20th century, the 21st century has already witnessed additional new and profound changes in all areas of medical science and research, including innovations and discoveries in biology, cellular biology, genomics and proteomics, pharmaceuticals, medical devices, and information technology. Some have noted that this recent scientific avalanche has already brought about a complete “paradigm shift” in certain approaches to patient treatment, such as for cancer, Alzheimer’s disease, organ and limb replacement, and various auto-immune system disorders.
Academic journals are hard-pressed to keep their audiences up-to-date on the unprecedented rapidity and scope of such changes. In the field of health services research, several journals have devoted entire issues and special sections to broad discussions of the products of the new science and their implications for patient treatment.
But the new discoveries keep coming, and it is becoming clear that even the biotech industries (which have long proclaimed their leadership in being “on the cusp” of transitional science in genetics ) are feeling some level of uncertainty about their mastery of current knowledge and future applications. As an example, the assumed independence of genetic operation (the so-called “Central Dogma” of molecular biology, which assumes that each gene carries information needed to construct one specific protein) provided the foundation for the biotech industry since the mid-1970s. However, recent reports note that these assumptions of gene functioning are under dispute (Caruso 2007). The possibility of networked gene functions reverberates well beyond scientific and technical implications; because it throws patent rights and intellectual property claims into a stew of uncertainty, it is also outpacing the ability of our current legal and organizational structures to deal with its implications for changing care.
Within this context, this brief edition aims to focus attention on the related but often overlooked aspects of organizational change that are being (or will be) influenced by the new technologies in medical care. At present, there appears to be a large and growing gap between the capacity of new medical sciences to develop innovative treatments and the capacity of scientific and treatment organizations to fully advance these innovations and adopt them for actual patient treatment. As that gap grows larger, we will more than likely see increases in systemic uncertainty in knowing how to proceed, increases in disparities in access to these new technologies, and increases in patient safety issues and quality of care concerns. That gap and its follow-on concerns will influence how we frame the discussion of medical innovation for the foreseeable future and might slow the pace of medical innovation in the long run.
Final year MBBS,
Grant Government Medical college,
DIRECTOR OF THE EDITION
Tirunelveli Medical College, Tamilnadu
ASSISTANT DIRECTOR OF THE EDITION