Summary:"What will be the cause of your demise," asked moderator Martin Greenberger, Senior Fellow with the Milken Institute. "Flip a coin. If it lands on heads, it is probable that you will die of stroke or heart disease. Flip it again and this is your chance that you may die of cancer."
One in five deaths is smoking-related, putting great stress on the nation′s economy. It is estimated that the economic burden of tobacco use, with both direct and indirect costs accounted for, is $150 billion.
The medical research policy panel focused its attention on prevention, where practitioners will be in the next decade, and what the new paradigm shifts are required with regard to where medical research and treatment for these diseases is heading.
David Kessler discussed his experiences taking on tobacco. "We went where no one else had gone before: inside the tobacco industry." Along the way, Kessler noted the loss in the Supreme Court and Philip Morris′ decision to promote regulation of tobacco stating that he believes that there will eventually be federal legislation regulating tobacco, reducing access to children and the appeal of the products.
On the issue of prevention of cancer and heart disease, Kessler spoke of the importance of medical student training. "At present, the number of actual students that can really take something from bench to bedside is very small."
Andrew von Eschenbach focused on the shift in paradigms with regard to the approaches for treatment and research. "We are embarking on a new era, one filled with hope and opportunity that did not exist before. The challenges of this new era will need to be addressed with us working collectively." With that, he said, we need to tailor treatment to individual disease, whereas before, the medical community treated disease empirically.
Richard Klausner spoke of the inefficient ways the medical community has traditionally treated disease. "It is remarkable how our approach to medicine and public health has been empirical, by trial and error. This is extremely inefficient."
More importantly, Klausner spoke of the need to decrease the gap between public health and medicine. "In the end, it is the linkage between medicine and public health that affect the burden of disease in all communities and individuals. We need to reduce the separation of these two approaches."
Ward Casscells spoke of the need for medical schools to do more to prepare students to be more creative and to generate and test new hypothesis. He believes that medical schools need to look at the next generation and look for ways to attract that future intellectual capital. Speaking on cardiovascular disease, Casscells remarked that it should have disappeared by now.
"Reducing the risk of cardiovascular disease is not just about cholesterol," he said. "For instance, we now know that you can reduce your risk of heart attack by getting the flu vaccine."
Thus, instituting policies that both combat smoking and promote such vaccinations can ultimately lead to a surplus in medical expenses. Casscells suggested that this surplus should be invested back into research.
