Medical professionals offering innovative solutions to some of the industry’s most pressing problems took the stage on Saturday at TedX Beacon Street in Brookline. Dr. Pratik Shah, a scientist, entrepreneur and innovator, discussed a new way to treat infectious diseases without antibiotics. His talk was later supplemented by ideas from Ayesha Khalid, a surgeon-scientist and innovator, who considered using a systems-thinking approach to fix our nation’s healthcare system.
Shah was one of three presenters who were part of Solve For X, a Google-led initiative that helps connect individuals and organizations in an effort to solve global problems. He focused specifically on the growing issue of antibiotic-resistant bacteria, also known as superbugs. “We need to start a conversation about managing infections diseases better in our world,” Shah said, noting that pneumonia and diarrhea alone kill approximately 2 million children under the age of 5 every year.
To facilitate that conversation, Shah studied the metabolites – the food sources for bacteria – that the human body produces when it gets sick, and found that the body produces both pathogenic and non-pathogenic metabolites. Disease-causing bugs have learned to avoid the non-pathogenic metabolites, he said, instead feeding on pathogenic metabolites, which cause them to produce millions of toxins that make humans sick.
“So I did an experiment in the lab: What if we made the bugs eat the non-pathogenic metabolites that they usually don’t eat?” Shah said. “And the answer was … they became avirulent. They toned their toxin production down.” That bacteria then left the body in a “safe, noninfectious state,” Shah said, opening the door for a new way to treat infectious diseases.
“When you get an infectious disease, rather than getting an antibiotic and killing the bugs, the first line of frontline therapy in the future should be – and could be – managing the infection by training the bugs, giving them food sources … that make them non-pathogenic, non-infectious,” Shah said. “And then, if needed, come back and treat it with an antibiotic.”
Shah is currently developing new oral rehydration salt solutions. When given to a patient with diarrhea, these treatments currently replenish the salts and metabolites lost during the infection, but do nothing to kill the bugs. In the next generation of these solutions, Shaw hopes to include non-pathogenic metabolites to treat the bugs.
“This buys us time to look for better antibiotics, which we are not able to find. And this allows us not to go back and start killing [bacteria] all over again, because we did that 50 years back [when antibiotics were invented], and right now, the bacteria is resistant,” Shah said. “This is a new approach where we have an opportunity to fix this problem the right way.”
Ayesha Khalid took the stage later in the day to discuss potential solutions to our nation’s large-scale healthcare problems. She began her talk by remembering a former patient, Charlie, who had seen seven doctors and undergone countless tests, incorrect diagnoses and frustration, before Khalid discovered he had a mass in his brain. (He has since received proper treatment and is doing well, Khalid said.) “But this is not a story about me as a doctor, or Charlie as a patient,” she said. “This is about the thousands of Charlies in the world who are unable to get a healthcare diagnosis.”
According to Khalid, 98,000 people die from preventable errors each year and 15 percent of all doctors visits result in a missed or incorrect diagnosis. So how can systems thinking help the medical industry cut down on these problems? “Systems thinking helps us understand how things are related – events, people and places – even if they don’t seem connected. And it also looks for leverage points – small actions that have really big impact,” she said.
Khalid then posed three questions aimed at finding that impact: How can patients talk to their doctors as a friend; why is competition so bad in health care; and why do doctors fear failure, and what can they learn from it? Establishing a new kind of patient-physician relationship, which Khalid described at present as “efficient, but not meaningful,” is an important step to changing the healthcare landscape, she said. “Shouldn’t seeing your doctor not be something that’s rushed? Shouldn’t it feel more like getting together for a cup of coffee?” Khalid asked.
She then discussed the harmful effects of the competitive nature of medicine, which tells doctors as early as medical school, they must get the best grades, make the fewest mistakes and work in the best hospital if they want to be a success.
“I found [that] all this enabled me to do was continue to focus on body parts that I operated on, and not really have a holistic view,” Khalid said. “And the bigger problem was that I was so focused on proving individual performance, on which we as doctors are measured, rewarded, and now publicly displayed, that didn’t really have time to collaborate with other doctors when patients were trying to get a diagnosis.”
Khalid’s final question addressed the importance of doctors being able to tell their patients, “I don’t know what’s wrong with you, but we can get there together.” Making a diagnosis should be a like a relay race, not a sprint, Khalid said, where doctors work together, and pressure to name a diagnosis quickly does not result it in being named incorrectly.
The talk seemed to offer more questions than answers – with each of her questions only leading to several others about how to implement these changes, a fact Khalid acknowledged. “I didn’t come here today to tell you how to fix the heath care system,” Khalid said. “I’m simply here to ask you if you even think that we’re asking the right questions.”
These healthcare conversations (combined with talks from many other sectors) continued on Sunday, too. Stay tuned for the rest of our coverage.
Have questions for Khalid and Shah? Join both of them on Medstro’s open TedX forum, where you can start a conversation about their TedX experiences and their professional work.
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