2016 saw many changes happening in the medical arena; some good, some bad, and some just interesting.  Many familiar characters played a role on the medical stage, more observed quietly, and some new voices rang out expressing what needs to be fixed and where medicine should journey.

A look back at medical highlights of 2016

1. The Bad

Perhaps the worst news of this past year was that US life expectancy fell for the first time in decades as the death rate increased. Increased heart disease and stroke deaths were thought to play a role as well as increased deaths from Alzeihmer’s disease, kidney disease, diabetes, respiratory disease, and unintentional as well as intentional injuries. The growing obesity epidemic may be a foundation in all of these.

Theranos was another blight on the medical stage. The biomedical start-up, founded by Elizabeth Holmes, promised to disrupt the way lab testing is performed by testing for hundreds of diseases with a single drop of blood. The company progressed into a billion dollar venture, until it was revealed as a sham. In fact, its basic scientific process was found to be flawed and no one from the scientific community would vouch for it.  In October 2016, Theranos ceased its laboratory operations, closed its wellness centers, and laid off approximately 340 employees, or 40% of its workforce. This followed scrutiny by the Centers for Medicare and Medicaid Services (CMS) in July resulting in sanctions against the company including a ban from operating a lab for 2 years.  In a letter to her employees, Holmes informed them that they would now focus on making miniature medical testing machines. It is clear that 2016 knocked Theranos off the start-up pedestal and it may never climb back up again.

Pharmaceutical companies found themselves under fire this year. In February 2016, former Turing pharmaceutical executive, Martin Shkreli, was brought before a Congressional hearing.  The year before Shkreli and his company was brought into the limelight for raising the price of Daraprim (a medication used to treat toxoplasmosis) by 5000%. Public outcry pushed them to drop the price back to a more reasonable cost. In late December 2015, Shkreli was arrested for security and wire fund fraud charges and he stepped down from his position at Turing. During the Congressional hearing, Shkreli took the Fifth and refused to answer questions.

In August 2016, Mylan pharmaceuticals sparked similar outrage by suddenly raising the cost of EpiPens (a medication used in anaphylactic reactions) to over $600 for two auto-injectors. This was done at a time when parents needed to purchase this medication for their children returning to school. Public outcry again caused the pharmaceutical company to back down and lower the price. But, the prices of many medications continue to creep up, to the limit of what the market will bear.

2. The Good

December 2016 heralds great news that teen drug use is down.  This decrease in drug use holds true for marijuana, alcohol, tobacco, and prescription medications. This annual survey has been conducted since 1975 and queries eighth, tenth and 12^th grade students. This year’s study was funded by the National Institute of Drug Abuse and over 45,000 students from both public and private schools participated. These reductions have been dramatic over the past ten years, especially in the case of nicotine.

On December 13, 2016, President Obama signed the 21^st Century Cures Act into law. This bill easily passed the Senate and Congress with little opposition. This bill is a true victory on many fronts. One is that it will help states fight the rapidly advancing opioid epidemic. Also, mental health will receive additional funding. Perhaps, most importantly, this bill will devise ways for the FDA to bring drugs to market at a more rapid rate than currently happens. Patients with rare diseases and terminal ones that have no cures now have more hope than ever before. Funding is being provided for more research.

3. The Technology

1. Wearable sensors: The market on wearable sensors continues to explode. Over the past year, many research trials were started to study how these devices can be incorporated into clinical practice and their effect on a whole host of chronic diseases. Look for them to become more clinically relevant in the next year.
2. Tricorder: If you are a Star Trek fan, you know what a tricorder is. On the fictional show, this is a handheld device with multiple functions that can be used for sensor scanning and recording and analyzing data. A medical tricorder was used to collect bodily data and diagnose diseases. This year, a company called Qualcomm set up a competition called Xprize offering $10 million to whoever brings this device to reality. Results will be out next year.
3. Robotic nursing: Italian robotics researcher, Elena de Momi, trained a robot to mimic human actions. It was observed that humans and robots can coordinate their actions effectively to do surgery as well as other activities. They are not meant to replace humans but to enhance their work because they do not tire and can perform an endless series of precise motions. More research is needed but healthcare robotics may be the way of the future.
4. Artificial retinas: The artificial retina has been in the making for the past decade. While they have been in use, the quality of the vision still has room for improvement. In August 2016, a group of scientists published their research demonstrating how to improve the precision of the prosthetic retina. Patients receiving these implants will have a much more visual future.
5. Lightbulbs that kill bacteria: Everyone has heard about the rise of super-infections and how hospitals can be reservoirs for these deadly pathogens. One company, Indigo-Clean, developed lighbtulbs that kill bacteria. The light emitted from these bulbs target porphyrins that are found inside of bacteria creating a chemical reaction inside the bacteria similar to bleach. 

4. The Innovation

1. Precision medicine: This year saw more attention and medical conferences around the topic of precision medicine. On February 25, 2016, President Obama participated in a panel discussion on the importance of the Precision Medicine Initiative passed in 2015.  Research in this field has already yielded many important discoveries in the treatment of diseases. Look for many more in the coming year.
2. Faster vaccines: Following the Ebola epidemic, the ability to produce new vaccines has never been faster. In fact, the Cleveland Clinic named this their top medical innovation of 2016.
3. Possible New Treatment for Parkinson’s: There has been a long history of the paucity of treatments available for Parkinson’s Disease. In fact, one of the most commonly used medications was discovered in the 1970’s. Yet, it is not a very effective medication and no new ones that work have been developed in the past several decades. Scientists from the Van Andel Research Institute in Michigan have found a possible effective treatment from a diabetes medication, MSDC-0160.
4. New tool for breaking up brain clots: A tiny tool, basically a stent removing device, can be used to remove a clot when medications fail. The American Heart Association approved its use and studies show that it can improve survival in certain patients with minimal long-term damage.
5. Womb transplant: On February 24, 2016, a surgical team at the Cleveland Clinic performed the US’s first ever womb transplant. It was a successful nine hour surgery and represents the first in a clinical trial of uterine transplantation. In fact, it is the first clinical trial of its kind in the US.
6. Malaria vaccine: In 2015, the WHO estimated that there were over 200 million new cases of malaria diagnosed around the world and almost half a million deaths. The year 2016 brought great news in the fight against malaria: a vaccine! The WHO announced on November 17, 2016 that it would be rolling out in 3 Sub-Saharan countries in a pilot study.

5. The Inspiring

Dr. Au Baraa and the Syrian doctors in the war zone:

Most of us see the news coming out of the war in Syria. Despite the bombing, death, and destruction, the Syrian doctors there continue to provide care for the sick and the dying, often at the cost of their own lives. The Physicians for Human Life report that 738 doctors, nurses and medical aides are counted among the dead.  Dr. Abu Baraa is a pediatrician trapped in the war zone of eastern Aleppo. Hospitals there have been destroyed and are no longer functioning. He has no medicines left to treat those who need it, yet he continues to work. Even now, the underground hospitals are destroyed. Despite the cold, lack if food, sleepless nights, constant shelling, and the fact that most of his neighbors are now dead or injured, he continues to examine patients.

In August 2016, Syrian doctors sent an open letter to President Obama pleading for help. Part of the letter states, “Last month, there were 42 attacks on medical facilities in Syria, 15 of which were hospitals in which we work. Right now, there is an attack on a medical facility every 17 hours. At this rate, our medical services in Aleppo could be completely destroyed in a month, leaving 300,000 people to die.

What pains us most, as doctors, is choosing who will live and who will die. Young children are sometimes brought into our emergency rooms so badly injured that we have to prioritize those with better chances, or simply don’t have the equipment to help them. Two weeks ago, four newborn babies gasping for air suffocated to death after a blast cut the oxygen supply to their incubators. Gasping for air, their lives ended before they had really begun.

Despite the horror, we choose to be here. We took a pledge to help those in need.

Our dedication to this pledge is absolute. Some of us were visiting our families when we heard the city was being besieged. So we rushed back—some on foot because the roads were too dangerous. Because without us even more of our friends and neighbors will die. We have a duty to remain and help”.

Doctors crying out from the land where little hope is left inspire us. All of us should follow our oaths so closely. They are the shining example of the calling of a medical profession. Let’s hope they survive to continue that mission.

About the Author

Linda Girgis MD, FAAFP is a family physician practicing in South River, New Jersey. She was voted one of the top 5 healthcare bloggers in 2016. Follow her on twitter @DrLindaMD.