Segment 10: Can Clinical Pathways Be Personalized?

Surabhi Dangi-Garimella, PhD, then asked the panelists whether clinical pathways can prevent patients from receiving more personalized care.

Blase Polite, MD, MPP, said that “personalized medicine” is another one of those tricky terms that are thrown around, but may have different definitions for everyone. In general, however, personalized medicine is about the genetic makeup of a tumor.

In this sense, pathways are beautifully suited for personalized medicine according to Dr Polite. “I can look and know that you have a mutation that makes it much more likely that you’re going to respond to drug X or drug …It sort of forces you to say have you looked for all these personalized things. Then we’ll drive you to treatment.”

Pathways allow the physician to go off-pathway when it no longer makes sense for the patient, but one should also avoid extremes. “If I am 100% on pathway, you should be worried about me. You should also be worried if I am 80% off pathway. There is some sweet spot in there that says I am taking into account clinical situations, and I’m still using the patient in front of me, the art of medicine, everything that I know about their social situation, their opinion, etc,” Dr Polite explained.

Dr Polite hopes that in using pathways responsibly, physicians will not be penalized too severely for still practicing the art of medicine.