By David Charles, MD
“Diagnose and adios.” The phrase was both a joke and a slight about neurology when I first entered the medical field in 1990.
Neurologists had the ability to diagnose patients, often with horrible, progressive conditions. But those same doctors had few, if any, treatments to prescribe. For patients, it was devastating. For medical students, it was a deterrent. I saw my peers choose other subspecialities, where they could be more help to their patients.
I held out. I chose neurology because I felt the field had the best opportunity for discovery and new treatments over the course of my career. I read about the pipeline of medications in development for neurological conditions and hoped that neurology would see great advancements in the coming decades.
And it has. I think specifically of patients with:
- Multiple sclerosis, the relentless condition that affects cognition, vision, strength and coordination. Treatment has evolved from steroids and physical therapy to a dozen medications, many of those being biologics. These medications can not only reduce flare-ups but also slow the progression of disability.
- Cervical dystonia, a condition that causes pain and involuntary muscle spasms in the neck. It went from having no meaningful options to being treatable with neurotoxin injections, which greatly reduce pain and improve head position.
- Migraine. A range of breakthrough treatments have revolutionized what it means to live with the disease, allowing people to regain their lives, advance their careers and contribute to their communities.
There also have been groundbreaking treatments for stroke, epilepsy and Parkinson’s disease, among other debilitating neurological conditions. Each of these discoveries was made possible by the industry’s willingness to invest in research and development of new treatments.
I’ve seen firsthand the difference that patient-centered care and access to appropriate clinical therapies makes in the lives of patients. I’ve also seen the devastation and frustration when barriers keep patients from these life-changing treatments.
And while we have made tremendous strides, there still remain so many neurologic conditions that don’t yet have impactful treatments, including ALS, Alzheimer’s disease and many forms of brain tumors.
That’s why it is necessary to ensure that policymakers at every level understand what’s at stake. We can preserve an environment that fosters innovation, one that promotes access to new and better treatments.
Or, we can pull back on progress, stifling the scientific energy and investment needed for new discoveries.
For 15 years, I’ve advocated for the former and I’ve seen my patients benefit. Now, as Congress takes a close look at the cost and value of medical innovation in America, they might consider how risk and research have advanced health care to the present.
I don’t want to imagine a future without innovation. Do they?
David Charles, MD, is a neurologist and medical director of a telehealth program in Nashville, Tennessee. He is founder of the Alliance for Patient Access.