Systems Biology Calls For New Ways Of Training Doctors

Medicine

Systems approaches to medicine will require a new way of training physicians. "Medicine is now practiced largely on the basis of the anecdotal experience of the individual physician," says Fred Sanfilippo, chief executive officer of the Ohio State University Medical Center. Meanwhile, systems biologists are busy assembling molecular information into models that describe and predict function at the cellular, tissue, and organism level.

"When you start dealing with all the parameters and system interplays that are going to be identified as correlating with best medical practice, relying on content and one's personal knowledge is out the window," Sanfilippo says.

Leroy E. Hood, cofounder and president of the Institute for Systems Biology, Seattle, agrees that medical schools will need to adapt to a new world of medicine. "One of the interesting questions is, Which medical schools are going to step up and embrace this fundamental new way of medicine?" he asks. "This is analogous to the Flexner report in 1918 that pointed out Hopkins, with its clinical and basic research, as a model for medicine of the future. Here's a model for medicine of the future."

One medical school that is starting to take steps toward a systems-driven approach to medicine is Emory University, which is collaborating with the Georgia Institute of Technology to launch the Predictive Health Initiative. The collaboration is a multidisciplinary effort involving biologists, computational scientists, and even sociologists and anthropologists, "all collaborating around this effort to change the health care system from a disease care system to a health care system," says Kenneth L. Brigham, director of the initiative.

The first step in the initiative's strategic plan is a center for health discovery and well-being, Brigham says. This effort will measure the impact of lifestyle and dietary interventions in healthy people and at the same time collect data to validate a number of other potentially predictive variables for clinical use.

"We believe that the predictive models that will be developed will not be disease focused," Brigham says. "They will be process focused. There are a relatively small number of processes that the normal body has to perform in order to stay healthy." He predicts that systems biology in the clinic will involve detecting deviations in those processes long before cells or organs begin to fail.

"There will be drugs that treat health rather than disease," he says. "At the earliest deviations of processes from healthy function, there will be interventions, and we will help develop those that will restore health long before disease develops."