28 Jun What will the future be like in integrative healthcare? A sleep -health fantasy
We all like to dream every once in a while right? It’s only natural. Well, I’ve been doing a bit more dreaming as the landscape of health care is changing. If I had a unlimited funds, what would I build? Here’s my attempt at answering with a little sci-fi flare 🙂
The Center for Integrative Sleep & Health
It’s 2030 and the United States is recovering from a tragic fad that evolved in about 2025. The United States Government, in collaboration with a few university laboratories developed a new sleep medication which provided one hour of sleep equal to 8 hours of deep restorative sleep. The medication was initially developed for military service men and women so they could be awake more hours of the day for patrols and surveillance operations. Once the medication was FDA approved however, it landed in the hands of civilians, particularly wealthy business men, transportation workers, and addicted veterans. While preclinical animal studies were conducted, unfortunately, human clinical trials were rushed because of the implication of the potential revenue this drug would yield for the drug company. Studies longer than 3 months studies were not conducted prior to its distribution. For unknown reasons, humans responded differently than the mice did in the preclinical trials after 3 months. After 6 months of taking the medication nightly, humans developed rapid onset of Alzheimer’s disease and began dying due to complications. The drug was soon removed from the market. The media covered this story closely and as a result, people became nervous about any similar sleep medication. The paradigm began to shift and the general population began to move away from believing that medications would allow them to skimp on sleep and a resurgence of interest in adjunctive, alternative, and therapies for sleep.
Coincident with the evolution of sleep aids, in 2021 a 19 year old student at the University of Michigan finally invented a replacement for the CPAP machine (continuous positive airway pressure) for sleep apnea, a sleep disorder that affected up to 70% of the US population in 2021. This non-invasive procedure involved taking a 3D image of the patient’s upper airway, neck, and nose and printed replacement tissue which allowed the patient to breathe normally and without obstruction during sleep.
In light of these changes, The Center for Integrative Sleep & Sleep Health (CISH) was founded in 2028 by a former faculty member in Psychiatry of the University of Michigan ;-). This comprehensive center addresses any and all sleep disorders and their contributing factors with an east meets west approach.
Upon entering the lobby, the patient sees that it is spacious with soft-pale blue walls. There is a small water fall over rocks in the corner. Soft calming music is heard over the speakers. The patient smells a mixture of peppermint and citrus-both stimulating to the senses. The environment conveys sophistication, efficiency, confidence, and reassurance that the patient will receive the best-cutting edge care.
There is no receptionist. The patient checks by placing their their finger print on a scanner and the file is automatically pulled up in the office of the treating clinician. Each patient is asked to arrive 15 minutes prior to the scheduled session. The clinician is alerted that the patient has arrived and takes this time to light a candle and meditate while centering in on that patient prior to their entry into the office. Beyond the lobby there is a long glass hallway with meditation gardens on either side. There are people sitting quietly and cross legged on one side and a few people practicing Thai Chi on the other side.
There are 10-15 offices, two conference rooms, a laboratory, and a fitness center. While waiting for the clinician, an automated carts rolls over and the patient places their arm on it. Vitals are obtained while the patient waits and they have a small puncture blood draw. The sample is dropped into a biohazard box inside the cart. The blood is immediately analyzed for a standard blood panel, cortisol, and obtains a “snapshot” of the patient’s microbiome. The machine is also able to detect a melatonin profile retrospectively.
The center is tucked away between the shore and the mountains. Trail maps are provided along with videos of doctors explaining the results of studies showing that walking in the woods can help with depression. The grounds around the center are well cared for with green lawn and flowers at the door. There is a garden and a greenhouse growing all the necessary herbs and plants to treat a number of diseases. Because the center is focused on sleep, it has the largest garden of Chamomile, St. John’s wart, Mother’s wart, and lavender. It also has a marijuana garden which grows specific strains of marijuana to aid with sleep.
When a patient is seen, the patient rotates through a number of mini-visits. They see a psychologist, a traditional western physician, a Traditional Chinese Medicine (TCM) practitioner, a nutritionist, and a homeopathic medicine practitioner. In a typical sleep medicine visit, the upper airway of the patient is evaluated to establish how crowded the upper airway might be (a mallampati score) which would increase risk for sleep apnea. In this part of the evaluation, the TCM practitioner would also be working side-by-side with the western MD to evaluate the tongue. The TCM practioner will especially be looking for a red tip tongue and (indicating fire) and would alert the psychologist and nutritionist. The physician and TCM would create a treatment plan blending the two approaches.
Acupuncture and acupressure
Lesson in Thai Chi
Summary and conclusion
Ok, so as Anthony Michael Hall said in the beginning of the movie Weird Science, “don’t mess with a fantasy.” It is a fantasy, but who knows, maybe this exists somewhere or maybe it can exist in the future? Would people get better faster if exposed to this kind of care or would the diseases in 2030 be even more difficult to treat? Who knows? It’s nice to dream about how we could best meet the challenges of the time. How would you change healthcare?