Therapeutics and the F1 race.....

There are quite a few variables operating in the context of an F1 race. Where the driver is concerned there are questions about his mental alertness, situational awareness, speed of reflexes, knowledge, experience and even his risk for appetite. Clearly there are also variables related to machine performance and conditions affecting road and track. All this variability create exciting conditions and an unpredictable outcome. Yet, no matter who wins eventually, most car-machine partnerships perform outstanding well.

The operation of any high performance machine system requires complex and sophisticated servo-systems operating at multiple levels. At its most simplistic level, the race car driver need to sense the speed of the car and adjust the speed through an interplay of acceleration and deceleration.

Precision therapeutics is really not any different. The physician must be able to recognize the effect of his procedures (drug regiment) and modulate these through the adjustment of his procedures (drugs dosages, for example). What is surprising is how many physicians do not recognize that they need to do this. They function like race car drivers who don't know their car, have no speedometer and are blinded. What's worse....don't even know they have brake and accelerator pedals.

For them, the patient is represented by a virtual description of a population average. Their expectation of a therapeutic effect is a relatively crude measurement of eventual outcome - cured, didn't work...died(often they don't even recognize they are driving blind). And they don't seem to realize, they can actually adjust drug doses in scientifically rational ways.

We can actually do a whole lot better than that. And many physicians have.