Sparked by an inquiry regarding a speaking gig around the future of do-it-yourself (DIY) medicine got me to thinking about how much the concept has changed over the years, and most certainly at an accelerating pace.
Back in 2011, I did a posting about a wonderful exhibit put on by the Philadelphia Art Museum called “Health for Sale“. It was a collection of poster art in pre-regulatory days used to market lotions, cough medicines, elixirs and all sorts of promises to cure what ails you, or might ail you. The exhibit provided a peek into the world of Do It Yourself health as it existed before there was any regulation – when any mixture put in a bottle could be sold as a cure for almost anything.
A lot has changed in self-care or DIY healthcare since then and some things have not. On the one hand, there is a whole agency now seeing to it that claims that are put to medicines are accurate. But on the other hand, the very concept of DIY healthcare is transforming and in many respects, involves new expressions where the regulatory side of things may have trouble keeping up.
People are becoming increasingly involved in their own care on a number of fronts since the days of Health for Sale. From seeking knowledge about a condition to treating and preventing it, there are new levels of involvement for consumers/patients in their healthcare. While once we were passive listeners in the doctor’s office, today we come in more engaged participants.
For starters, the patient, some might say, became more enlightened with the advent of direct-to-consumer advertising – others might not. Whichever way you fall on that, it is a means of spreading information about conditions and treatments that was not available prior.
In addition to DTC, there is a huge industry in supplements – the ability to self-prescribe and self-treat and seek to prevent conditions with products that are not drugs. And for those that prefer drugs, in the 1990s there was a pretty large migration of products from RX to OTC status – drugs which treated symptoms like allergies and rashes and heartburn to drugs that treated conditions like GERD – a switch pipeline that would appear to have slowed somewhat these days by comparison.
And then there are home remedies. In the early days of the AIDS epidemic before there were any antivirals on the market, people tried growing mushrooms in their homes to make tea or concocting formulas that were passed around for homemade treatments that would do something in the face of a growing epidemic where medicine offered nothing.
Today it is technology that has come to play a much bigger role. First of all, there is Dr. Google – the ability to look up information in whatever form and from whatever source, either Facebook, Wikipedia or the treatment guidelines of a medical society, at the very least giving a patient something more to talk about during the medical visit than in 1985.
Social media allows one to crowd-source – to share symptoms and get opinions and help from friends and from strangers alike. It allows for an enhanced referral process and rankings to assess a provider. And patients can find much needed support in guidance from other patients and in discovering the existence of much needed resources.
Today, one can use one’s phone for a phone call, but is much more likely to be used for other things – many of them health related. With the advent of apps, you can check blood pressure, monitor activity, count calories, check on your sleep patterns or a host of other medically related endeavors. Or if you choose, you can get a wearable device to handle some of that load. At some point, you may use it to monitor more than functions. Perhaps in the future you will be able to do things like monitor your own liver function or cholesterol level -which might open the way for the RX to OTC switch of cholesterol lowering medications.
In the past 25 years, there has been a tremendous evolution of DIY care. Some of the change does not eliminate the medical presence, but makes it more convenient and accessible and which rely more heavily on the patient in some respects – such as Telemedicine.
Through all of this, the regulatory aspect has struggled to keep up. FDA still struggles in completing its task set out in 2009 regarding guidance in the use of digital and social media platforms. Many apps were on the market before FDA began addressing that category. Change does not occur in a vacuum. New developments and their uptake are occurring at a much faster rate than their regulation and when you think about it, DIY is an entire evolving health industry segment signifying perhaps how far we have come from the days of Health for Sale.