Top 10 Advances in Medicine (6-10)

I’ve been thinking lately about all the great advances in medicine over the years. There have been lots of them. And despite everything you’ve heard about looming cuts in healthcare, I have no doubt that the hits will keep on coming. Since I seem to be on this Top 5 thing lately, I figured I would continue this ride and rank my top 10 medical advances over the years. There had to be a few ground rules before putting together a list like this. I’m a medical doctor ranking medical therapies, and so surgical advances can take up space on someone else’s server. And just to be clear,  since it’s been awhile since I’ve treated malaria and cholera, I’m going to stick to western world problems and western world drugs.  I’m also not the young idealist I once was, so public policy initiatives, like seat belts, clean drinking water, and vaccinated babies are being tossed out with the bathwater. No, we’re talking about good old fashioned chemicals with long complicated names produced in soot belching factories and administered in our nations pharmacies and hospitals with epic markups to ensure future stock gains research funding.
So without further delay, and with no pre-authorization required, here is the latter half of the top 10 medical advances.

10. Psychiatric Meds. One has only to look at the CDC’s list of the top causes of mortality in America to see the logic behind this choice, as suicide rounds out the top 10 causes of death. But psychiatric problems also have a much greater impact beyond suicide. Problems like depression and anxiety often exacerbate other medical conditions, increasing the risk of complications.  They put strain on family members and cause lost productivity and income. They are one of the most common reasons for enrollment in disability.

9. Inhalers: Nothing says “thank you, doctor” like a patient who can say “thank you doctor” because they now have sufficient lung capacity to actually utter the words. From infants to nonagenarians bronchodilators of various type and brand  routinely open up peoples airways and help them stay that way. While there may not be randomized controlled trials to show this, its generally accepted as fact that people who can breathe are happier, more productive and generally healthier all around that people who can’t.

8. Oxygen. Maybe being a pulmonologist I’m a bit biased on this one. But it seems to me that oxygen as a medical therapy is, well, elemental (sorry). It’s one of the first things they slap on you when you get to a hospital, because it’s the one thing none of us can live without. Think of all the people who come into the hospital in some sort of distress; many go on to have a procedure of some kind. Many of those people would not make it to, or through, their life saving intervention without oxygen. Yes, it seems that oxygen is the one drug we’re all addicted to, and luckily, it’s free as long as you don’t want more that 21% of it. I occasionally ponder if its actually the most commonly prescribed drug in hospitals (probably after pain meds. See next list)

7. Cholesterol lowering drugs. Of the top 5 causes of death in the U.S. 2 of them involve vascular disease (heart disease and stroke), which explains the presence of this class of drugs on this list. The reduction of cholesterol by these medications (predominantly statins) has surely reduced the burden of disease caused by vascular disease

6. Blood Thinners. Anticoagulants have come a long way since the days when the Wisconsin Alumni Research Foundation (WARF) funded research to determine why cows who ingested spoiled feed were dying from hemorrhage (the causative agent was named warfarin). There has been a veritable explosion of late of newer anticoagulants which now come in various forms and can be used for a variety of purposes. Treatment of everything from heart attacks to stroke prevention would not be possible without them.

Come back in 2 weeks to see what made the top 5. What would you put on your list?

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