KEYNOTE | DAY 2 - 1 NOV 2016 Raymond Borger, Medical Doctor Vitaalplus+ (NL) Games for Health Europe 2016

1. Confessions from a doctor from the 21st century:
how doctors travelled from low tech to high tech
(but actually might consider going back again a bit)
Raymond Borger M.D. Vitaalplus
“The physician is only nature's assistant”
-Galenus- 129 AD – c. 200/c. 216

2. Confessions No 1

3. Confessions No 2

4. Who’s in for some happy endings ?

5. What about some free, low risk, easy and
pleasurable health promoting interventions
(that even might prolong your life a bit?)
contibute to
prevention of several diseases
increase of vitality
raise mental health, mood and
quality of life

6. Dutch Society for lifestyle medicine
www.avlg.nl info@avlg.nl

7. Ultra-short history of modern medicine
we’ve come a long way: low tech to hight tech

8. Rational research of Galen’s nature: zooming in
Diagnostics
Knowledge & Skills
Rational treatments

9. Evidence Based Medicine
Rational interventions
protocollized medicine based on high quality RCT’s

10. Ned Tijdschr Geneeskd. 2010;154:A1910.
The role of epidemiological evidence in providing care for individual patients.
Smulders YM1, Levi M, Stehouwer CD, Kramer MH, Thijs A.
Proven efficacy of treatments based on high quality research

12. Decline in cancer deaths
death per 100.000 citizens
FemalesMalesCases
Year

13. New Big stakeholders in healthcare
2015
2016

14. Confession No 2

15. We’ve come a long way: low tech to high tech
an ultra-short history of modern medicine

16. We ourselves have come a long way too
Average lifespan
25-30 years 40 years 80 years
1860 2016Stone age

17. Life-span vs
Health-span
Healthspan
Age related
diseases
Total lifespan

20. Lifespan vs
Healthspan
Healthspan
Age related
diseases
Total lifespan
€
$

22. Lifespan vs
Healthspan
Healthspan
Age related
diseases
Total lifespan

23. Artificial Intelligence
Lab on a stick
genome editing CRISPR-cas
Personalized medicine
Some great promises for an
everlasting heaven of health
Eternal youthful living
Quantified selfBig data analysis
Genome sequencing

24. Lifespan vs
Healthspan
Healthspan
?
Age related
diseases
Total lifespan

25. Gene editing: who wants to live forever?

27. 1
Science:
The good,
The bad and
The ugly

28. Confession No 3
Working with protocols based
on best available
evidenced base medicine
2

30. What about…..
placebo smoking
placebo diet…,
placebo exercise…,
Placebo clean air
placebo laughter…,
placebo friendship…,
placebo meaningful life…,
etc, etc.
major problems with RCT’s3

31. Substituting approaches in health care…?
Zooming out in (rat)race and time

32. Zooming out: Time
140.000? 6-10.000 150 50
Homo Sapiens

33. Zooming out: Race
(human race)

34. 4 healthy life-style factor
23.153 participants aged 35-65 jaar followed during 7,8
- 93% less chance at becoming diabetic
- 81% less chance on myocardial infarct
- 50% less chance on cerebrovascular accidents
- 36% less chance on cancer Healthy living is the best revenge: findings from the
European Prospective Investigation Into Cancer and
Nutrition-Potsdam study.

35. Confession No 4
Hippocratic oath

36. Healing environment
Evidence based Medicine
Resolving
loneliness
TLC
Detoxification
Bio-hacking
Nutrition
Bibliotherapy
Phytotherapy
Biorythm
Stress-copin
plied physiology
Electrotherap
Biofeedback
Being in Nature
Cryo & thermo
therapy
Nutraceuticals
Big Data based
interventions
Laughter
App’s
Games
Sociotherapy
Placebo-effect
Pre-/probiotics
Hormesis
Sense of Coherence
Systems biology
Mindfulness
Hypnosis
Salutogenesis
Health promoting
therapies
Enviromental
interventions
(Pulsed)
Electromagnetic
fields therapy
Effective life-style
interventions

37. Confession No 5
Hippocratic oath
Primum non nocere

38. 2013

39. ? Decline ? of
-shared meanigful narrative
-sense of coherence
-social cohesion ($/€ crisis)
-existential skills

40. Confession 7: I morphed into a
health architectR

41. Examples for serious games for health
Games that facilitate compliance to healthy lifestyle habits
-diet
-exercise
-stress-reduction / stress coping
-sleep quality
-beating addictions
-beating loneliness / creating connectivity
-cultivate meaningful narratives
-patient education in general
-many many more

42. Rational research of economical data
other rational
medical
diagnostics &
interventions ?
High tech
High knowledge / skills
High patent
??

44. Business model current Medical model Games model
Aimed at (curing) / treating
diseases
+ promoting health &
Quality of Life
High evidence +++++ / ? - - / ++++
High tech +++++ - - / (+++)
Highly patentable +++++ - - / ?
High skill +++++ - / (+++)
High knowledge +++++ ++++ (creativity)
High risks +(+++) - - - / (+)
High patient autonomy - - +++
Pleasant - - +++
High costs +++++(+++) - - -
patient involvement - - - +++(+++)

45. Now before we go out ….

46. ….and co-create rational
health-care substitutes
aimed at a more healthy,
meaningful, awe-inspiring and
possibly even numinous future….

47. …what about that promised happy endings
with some free health longevity-hacks?

48. Thank you for your attention!
r.borger@vitaalplus.com
www.avlg.nl www.vitaalplus.com

50. Interesting readings