What do we expect from the medicine of the future - prevention, gadgets, technology, or all the same

Changes in medical attitudes are not always visible up close, but over time they become apparent. If nothing had changed, our teeth would still be treated by hairdressers, and hospitals would not have MRI machines. Sooner or later, the future is coming: let's look at what medicine will be like in 10-15-30 years, based on the technology and devices that exist now. If the XX century predominantly directed man's scientific interest outward and continued to push for discoveries related to space and the depths of the sea, the XXI century can be safely called an era of search within. Mankind has discovered high technology and, of course, the boom of innovations, gadgets and technological solutions cannot but affect medicine, turning the idea of what will underlie it in the future upside down by 180 degrees. The traditional health care system is largely fragmented, whereas technology can offer an interconnected solution to the individual. Whereas now the human encounter with medicine occurs when illness has manifested itself, in the future medicine will be a continuous process of preventive health care and will move from treating illnesses to preventing them. The basic concept of the transformation of medicine of the future is the 4Ps: predictive, personalized, participatory and preventive. Medicine of the future is not about "treating the sick" but about making sure you don't get sick at all! Thinking about a person's prenosological state, monitoring and finding this stage is the main task of medicine of the future, as the current situation with the coronavirus epidemic perfectly illustrates. Right now, we see that all public health efforts are primarily focused on assessing risks and preventing new diseases. Just 30 years ago, scientists could not have imagined that one day they would be able to decipher the genetic code - it was thought to be impossible. Now, DNA can be used to determine a person's susceptibility to breast cancer, type 2 diabetes, intestinal inflammation and heart disease. And although this is only the beginning - scientists still have a very long and grueling search for connections between specific parts of the genome and diseases - it is likely that in 10 years, an individual DNA profile will become a mandatory part of each patient's medical record. The essence of this approach is to find the best treatments for a particular person based on his or her own, unique biochemical characteristics. So, by reading the DNA of a patient's cancer cells, one can identify specific mutations and see which of hundreds of drugs and millions of combinations of treatments would be most productive. Or determine which of the patient's own lymphocytes are capable of attacking cancer cells. After the "good" cells are grown in the lab, they are injected into the patient's body, where the restored immune system begins a targeted fight against the cancerous tumor. There have already been successful precedents of cancer cures in this way, but, of course, these are only the first rays of hope - it is still too early to talk about mass healing. Or, for example, tissue analogues of the affected organs are already being grown from the cells of patients, thus creating "living" models for testing. Subsequently, they are used to analyze how the organ of this particular patient would behave if a particular drug, including an experimental one, were applied to it. This approach ensures that time is not wasted and the patient's condition is not exacerbated by a therapy that does not work. To make predictive medicine a reality, regular data collection is needed - and that's where gadgets help us. The first steps in this direction, for example, explain the rise in popularity of biohacking with its desire to provide monitoring of everything in the world. Even now, smart fitness bracelets, which have long become a familiar attribute of everyday life, are able to count many health and physical condition or activity indicators: the number of steps per day, HRV, blood pressure, sleep and exercise quality, the number of calories consumed, frequency and time of meals, weight, body composition, etc. Most likely, it is sensor-based wearable technology that will become the basis for disease prevention, diagnosis and therapy in the future. What other important medical technologies, gadgets and devices exist now, and what are we looking forward to in the future? The main task of medicine of the future, all this gene analysis, cell programming and tissue engineering, is to give people control over their own health, previously simply unthinkable. And the helpers in this will be painfully familiar gadgets - who knows, maybe very soon the refrigerator will monitor our diet and advise to throw away the extra package of ice cream, the phone - to determine the degree of depression, and toothbrushes - to analyze the daily composition of saliva, in time to notice the first deviations from the norm.