Old and new methods

Cuttsy+Cuttsy | 26 October 2016

Advances in technology provide new options for healthcare professionals and often yield better results; we can perform more precise operations through smaller incisions thanks to robot-assisted surgery, and we can treat diseases more effectively, with fewer side effects and more convenient dosing schedules, using new drugs with novel mechanisms of action.

Tools like these are fantastic to have at our disposal, but it can be easy to forget about the older options when a new technology comes along. Sometimes, methods that may seem relatively old-fashioned and even outdated can provide the best and most appropriate solutions.

A good example that is often seen not only as outdated but also barbaric is electroconvulsive therapy, or ECT, in which a seizure is induced in a patient to treat severe depression. Doctors had noticed that patients who had epilepsy and certain mental health conditions felt better after having a convulsion, and so they attempted to provoke seizures, first using chemicals and later with electric currents. Therapies based on this principle have been around since the sixteenth century, but its development began in earnest in the 1930s.

ECT was widely used in the fifties and sixties but it has tailed off considerably since the 1980s. Its reputation has been very badly affected by how it has been dramatised, where it appears more like an electric chair than a medical procedure.

In reality, the patient is anaesthetized and given a muscle relaxant. They feel nothing and the muscle spasms are minimal—not as dramatic as films can make it seem. It is only used to treat severe depression, and even then only after other options have failed. ECT can save people’s lives, and remains a vital treatment option.

Another odd therapy that was largely forgotten about but never entirely consigned to history is the faecal microbiota transplant (FMT). This was popular in sixteenth century China (in the revolting form of a sort of stool broth, known as ‘golden syrup’), but has seen a resurgence in recent years as an incredibly effective treatment for C. difficile infection in patients where antibiotics haven’t worked or the condition has returned. By recolonising the large intestine with the normal bacteria that have been lost, the C. difficile appear to be neutralised and the symptoms of infection clear up very quickly and with very few side effects. Mercifully, the transplanted gut flora is delivered nowadays in a freeze-dried capsule or as an enema, but at the heart of it the treatment is essentially the same as it was hundreds of years ago.

Neither of these are first line treatments any more, but there are still occasions when they are the most appropriate choice. It is also very important that they have been updated to fit modern standards of care. They should not be thought of as old-fashioned, but rather as viable options to use in specific situations.

This is also true of certain communications media. Now that audiences can be engaged in lots of exciting ways, such as through apps or virtual reality, the traditional media can seem unattractive—but for particular target groups they remain the most effective channels. The advantages of interacting with patients through websites or mobile phones are completely negated if your audience does not use the technology confidently, and information is hardly confidential if the patient needs help to access it. Traditional media can be updated and modernised, just like the old medical treatments, so they feel fresh while doing their job well. Printed materials are not yet a thing of the past.

The important thing is to know your audience and understand their situation, which is something we work hard to do at Cuttsy+Cuttsy. While we love the new methods of connecting with audiences, we recognise the power that the old ways have and we always recommend the most appropriate channels to our clients.