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Pills and Paternalism

August 6, 2012 By Bryan Vartabedian · Reading Time: 2 minutes

Proteus announced last week that the U.S. Food and Drug Administration (FDA) has cleared its ingestible sensor for marketing as a medical device.  This ingestible sensor is part of a personal health management system designed to help monitor medication adherence.  The sensor is integrated into medications and when it comes in contact with intestinal secretions it sends a signal to a small patch on the skin that detects the time of ingestion and other information.  This is, in turn, sent to a mobile application where the information is recorded and accessible for later review.

This is a remarkable development in terms of understanding the dosing patterns of individual patients as well as populations of patients.  Information never accessible has the potential to change the way we recommend medication usage.  The potential is mind-boggling.

It’s interesting how people see this development.  I read Fred Trotter’s take on the Proteus approval over on O’Reilly Radar and shared it on Twitter.  The response was interesting in that a couple of people saw this as fostering paternalism.  There was a reference to Big Brother.

So will patients want their doctors to know when they haven’t been taking their meds?  Do we really want the doctor to ‘know everything?’  I suspect the answer may surprise us.  Patients are notoriously private about their habits, even with those to whom they entrust their care.

Proteus has me thinking about prescriptions and the relationships we share with our doctors.  Do we want adherence to be our own private business?  Or is there a role for some level of paternalism in even the most progressive patient-provider relationship?

Adherence and the complexities of disclosure with a provider are the subject of bigger discussions.  But I suspect that Proteus may open up a whole line of very interesting dialog surrounding the self-imposed limits of disclosure with doctors.

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Bryan Vartabedian, MD

Bryan Vartabedian, MD
Bryan Vartabedian is the Chief Pediatrics Officer at Texas Children’s Hospital North Austin and one of health care’s influential
voices on technology & medicine.
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