If you are interested in biology, become a doctor; If you are good at maths, become an engineer. This is a long-standing saying and is still heard in drawing room discussions. However, engineering is not just about numerical skills. It is still dominated by fields that have existed for more than a century, such as civil, mechanical and electrical, and, more recently, computer science.
More importantly, we rarely realize that well-established protocols drive medical practice, and biology is not uppermost in a doctor’s mind when he or she treats a patient. Biology and math undoubtedly play a role in their respective fields. But compartmentalizing has a downside.
Why don’t doctors think about biology during treatment? Let’s take a step back and look at a car. Most components in a conventional automobile are made of steel or cast iron. Let us now discuss the role of the mechanic who repairs this car. The mechanic analyzes the various sub-systems not with knowledge of steel metallurgy but with an understanding of the functioning of the sub-systems. It’s not that he ignores the material; He looks at the problem at hand and portrays it as a system problem. In simple terms, an automobile can break down for a number of reasons. Although the role of materials scientists in auto design is undeniably high, the vehicle’s designers are mechanical and electrical engineers.
Let us replace our automobiles with human bodies. Like automobiles, our bodies can be staggered in a hierarchy. The chemical layer with molecules and membranes is the building block for cells. We can travel up the hierarchy through tissue, organ and whole body system. Doctor is our mechanic and corrects the malfunction of our systems and subsystems, by understanding the physiology the mechanic does it by understanding the subsystems. Doctors are not biologists, although they take the help of biologists through medicines and tests. Let’s not take the analogy any further. After all, the doctor deals with a much more complex problem!
Good clinical practice requires an excellent understanding of physiology. The traditional approach to physiology is to understand function – an input-output protocol. Another perspective is to look at it from the laws that govern its process – conservation of mass, momentum and energy. These laws form the basis of all engineering systems, be they mechanical, chemical or electrical.
In simple words, understanding of physiology can be enhanced by learning the principles used in engineering practice. We can say that physiology, at its core, rests not only on biology but also on engineering science. Then, we have the birth of a new branch, engineering physiology, engineers who, with knowledge of physiology, pathology and treatment protocols, interpret or grow from the underlying engineering science.
Interdisciplinary teams, quick decision making, risk stratification etc are jargon that you hear in the corporate corridors. Little do we realize that physicians have been practicing these principles for a long time. Treating a complex case requires multiple inputs from multiple specialists. The future of medical practice should include an ‘engineering physiologist’.
To consolidate the ideas, imagine a complex case being discussed by a group in a hospital in the year 2030. This group may include an engineering physiologist. He can create a digital twin of the patient, test treatment protocols, and interpret pathology and clinical measurements. This new breed will enhance the understanding of the treating doctors about the patient’s condition.
It is not that the engineer-physiologist will just sit in the hospital. If one traces the history of medical product development, many ideas have come from practicing physicians. Then a doctor-engineer pair creates a product. We stopped calling these engineers biomedical professionals. Yet, in the bridge between the domains, the Engineers stand at one end and yell at the Doctor at the other. Hardly anyone walks on the bridge, making the current practice inefficient. Imagine an engineer who has complete knowledge of clinical customs. However, they will not practice but understand the profession in depth – an engineer who knows surgical protocols!
Such a breed does not exist today. Biomechanics is believed to bring the fields together, but this remains a research topic. National biomedical design is at a peak. This is in a state where two decades ago there was a pharma industry. With tight patent controls, the sector craves for innovation that stems from a good understanding of the domain. The new breed will admirably fill this gap.
Engineering physiologists can perform many other roles. It is well recognized in engineering that system function is critical to material development. Engineering physiologists entering drug development are the way to combine engineering skills with biology, leading to disruptive innovation.
Open your newspaper in the morning with a cup of coffee. The application of artificial intelligence and data science screams from every other page, with the health sector topping the list. Data analysis in medicine cannot be mixed with the rest of the field. Without understanding cause and effect, it is nearly impossible for the medical community to accept results or treatment protocols based on AI/ML. Here is a group of men and women, engineering physiologists, who can straddle both worlds – data and medicine.
Our top educational institutions should look beyond classical branches and those with immediate appeal, such as data science. They have to define the future, the field of study which will take a leap in science and engineering and technology. An engineering physiologist with a strong background in math and medical science could define the future of medicine.
Are they ready for such a disruptive move?
The author is Institute Professor, IIT, Madras