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As physicians and advanced practitioners of gastroenterology, we practice in a “Brave New World,” the title of Aldous Huxley’s 1932 dystopian novel that depicts a frightening vision of the future. For health care, that scary future is now. Every day, I am inundated with misinformation spread by the media and internet about what ails the gut, and how diet and supplements can help cure us. Candida overgrowth, leaky gut, food allergies, probiotics, prebiotics--these have formed the basis of alternative approaches to management of gas, bloating, diarrhea and abdominal pain when there is no obvious cause or cure.
As we struggle to keep up with the information highway (or should I dare say, Hershey Highway, sorry Milton), we also have the pressure of healthcare integration, where gastroenterology practices partner with private equity to create more leverage in the marketplace, but at the same time, give up control of their practices. Surely, the landscape of gastroenterology will look vastly different in ten years.
When Huxley’s futuristic novel was published in 1932, my grandfather Dr. Chai Chang Choi (pictured above) was in his second year of medical school, three years after the discovery of penicilin. We now use penicillin- derived antibiotics to treat H. pylori and other infections of the gut, but these same antibiotics can wreak havoc on what we now call the microbiome, leading to c. difficile infection and irritable bowel syndrome. A brave new world indeed!
As we trudge valiantly into the rapidly advancing winds (a tad smelly perhaps) of progress and change, I wanted to create a learning environment for non-physicians that mirrors how medical students and resident physicians learn in the hospital, presenting all of the facts and clinical trials in an interactive group to arrive at the most likely diagnosis and best treatment.
