What Exactly is the P4 Medicine?

That prevention is better than a cure is a proverb people voice the most and yet apply the least. Such is the sorry state of the current healthcare approach too. Doctors may argue much on how they are the saviours but most people on any street would call them more concerned of themselves rather than their patients, a clear infringement of the oath these demi-gods take on their graduation. Doctors graduate from medical schools having mastered techniques of a particular trade of interest and they refuse to ‘move’ ahead in life, adopting newer innovations, because they only know how to use the technique and not how techniques evolve. If they embrace developing techniques, they tend losing their ‘sharpness of observation’ as physicians.

The pioneer

Leroy Hood, Institute for Systems Biology, envisions a fairer view of medicine. He dreams of transforming the healthcare sector from being a ‘cure’ to a being a ‘prevention’. The four P’s are personalized, predictive, preventive and participatory. As he quotes,

“the changes will be catalyzed by a new systems approach to disease that will trigger the emergence of personalized medicine — a medicine that focuses on the integrated diagnosis, treatment and prevention of disease in individual patients. The convergence of systems approaches to disease, new measurement and visualization technologies, and new computational and mathematical tools can be expected to allow our current, largely reactive mode of medicine, where we wait until the patient is sick before responding, to be replaced over the next 10 to 20 years by P4 medicine that will be cost effective and increasingly focused on wellness.”


Detection of diseases at the earliest possible phase would mean cheaper and more efficient treatment. Once a disease is diagnosed, side effects of drugs can be reduced to nil by accurate assessment of drug response based on the patient’s genetic make-up. Clinical trials and drug design would become cheaper, quicker and far less prone to failure.

Cost of proper health has escalated to enormous heights to the extent in some regions that the average income is below what they should be spending on health alone. P4 would reverse this growth into a steeper decline. Healthcare, cheap yet excellent, would be a possibility for each of the seven billion residents of our earth. Though many social, ethical and healthcare issues are anticipated, but it is hoped that biotechnologists of the future would let their work speak for them.

Picture credits: Ohio State University
Picture credits: Ohio State University

How, exactly?

Genome sequencing is getting cheaper by the year. Population ecologists are hopeful of someday sequencing gene pools to study variation in species.

Symptoms of a disease begin to show when the number of the causative pathogen increase beyond a certain value. Techniques in bionanotechnology are under research which would determine the levels of biomarkers related to the pathogen concerned or physiological or histological changes due to the disease at the earliest possible phase.

Secure, effective databases are a must. Mathematicians and IT professionals may soon succeed in gathering maximum information from molecular data of individuals.  An upcoming book on genomic engineering has all of its content encoded in a DNA sample. The idea of storing patient data in their very own DNA so as to continuously monitor his medical history and probable future health at the same time may seem to most a daydream, but, is very appealing.

Methods to develop pluripotent cells from normal cells and differentiating them back to specific cell types were achieved by Dr Shinya Yamanaka in 2006 but implementing their theoretical advantages remain the most alluding objective.

Better imaging techniques to follow diseases and action, response, determination of optimum dose of drugs are inevitable. Summarily, the first of their kinds of systems biologists, computational biologists and data analysts would be looked forward to.


The challenges, mentioned above, that are to be met to achieve P4 are wide open to the upcoming breed of biotechnologists, provided that they dare to look beyond their classrooms or in the case of the practising ones, their specialisations.

One must know how the present level of understanding was reached, but if you waste precious time on outdated techniques (or studying them), you could miss the chance to do something that you are the first to do. I don’t remember the author but I read this in an article on game programming and would like to share –

“To succeed beyond measures, either be the best or the first and if you can be both, you have created history.”

By the way, Leroy Hood invites clinics, institutes or individuals who would like to help P4 surface.


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