The new generation must focus on disease prevention, proven treatments supported by science and the reduction of costs that could threaten the country financially.
Speaking Thursday at the school’s Hooding Ceremony, Brawley, the chief medical officer for the cancer society, said that for too long medicine has focused on “sick care” that waits for patients to get ill instead of trying to prevent illness.
“Disease prevention must become a greater focus in medicine, and I think you are prepared to do it,” he said.
A big reason for that is money.
The U.S. spent $2.6 trillion on
health care last year, compared
with $1.1 trillion on food. If it
were its own country, U.S. health
care spending would be the fifth-
largest economy in the world, ahead of France, Brawley said.
One of the biggest problems is obesity, which was 15 percent among adults in 1970 and is now 35 percent. Obesity, high calorie intake and lack of physical activity cause diabetes and heart disease and are linked to a dozen cancers, Brawley said.
“Obesity in the next decade or two will become the leading cause of preventable death, surpassing tobacco,” he said. “This trend must be stopped. This will be your challenge, ladies and gentlemen.”
The challenge goes even beyond health care, Brawley said.
“Health care costs, which are going to climb because of that obesity problem, are already threatening the very foundation of the United States, not just the U.S. economy but the very foundation of the United States,” he said.
Brawley has hope in the new doctors.
“I am optimistic you can overcome these challenges,” he said. They can do that by avoiding the mistakes of many previous generations, who believed a treatment or a procedure worked rather than relying on scientific evidence, which often later showed the treatment to be wrong. “The history of medicine is riddled with mistakes (from not following the science),” Brawley said.
For instance, the rush to screen for and treat prostate cancer in the past 20 years now appears to be wrong, he said.
“We’re starting to realize we jumped the gun,” Brawley said. For that reason, he urged the graduates to question convention.
“Always, always question what you know,” Brawley said. “Look for evidence-based medicine. Practice orthodoxy. Practice the science.”
“It’s actually a great time to be in medicine,” he said. “I’m really jealous of you guys because you’re coming to medicine at a time when there are so many opportunities, so much understanding of disease and how it needs to be treated that simply were not available even 10 years ago.”
Having had the chance to talk with and meet the class makes Brawley optimistic.
“You guys are going into this for the right reasons,” he said. “I really appreciate that.”