by: David Kashmer, MD MBA (@DavidKashmer)
By now you’ve probably heard of 3D printing. Sometimes, 3D printing enthusiasts are referred to, collectively, as “makers”. Well, let this maker tell you: 3D printing has wide applications in Medicine–so much so that it could do very well as its own specialty. Here are three reasons we should create a new specialty in Medicine that focuses on 3D printing:
(1) Truly Personalized Medicine
The push to serve patients with a focus on their unique needs is on in full force. Whether it be genetic testing to predict response to anti-coagulation, recognition of the necessary Prograf dose as adjusted for metabolic variation, or a focus on specific social factors, personalization of the practice of Medicine is becoming a buzzword that’s hotter and hotter all the time.
3D printing is a way to truly personalize that medical experience. The vascular surgeon can size your aortic graft preoperatively from a model created from your own CT scan…or surgeons can even replace / stent your trachea with a new one generated from images of your old one.
This can already be done and is getting easier with time. So, much like the rise of Radiology focused on imaging studies, let’s consider getting really good at creating personal models, devices, and anatomic replacements by creating a field devoted to just that.
(2) One-off, Specialized Medical Devices
Having a hard time fitting an ostomy appliance near an open wound? Is the effluent from the ostomy leaking into the wound bed? Why bother with all that? Create a custom printed ostomy appliance from a 3D scan of the patient’s abdomen. (We can already do that.)
Want to get really fancy? Upload your custom-tweaked design as an .STL file to the “app store” of compassionate-use approved, one-off medical devices. (Here’s something that’s an early version of what I describe.) No manufacturer could justify a large batch run of the perfect device you’ve created for a small (but important!) patient population…but those of use with printers (and those same patient issues you have) could go to the “app store”, download the .stl file, and create that medical device to solve their patient’s issue.
A field devoted to creation of these models, knowledge of filament types, and understanding of model usage would go a long way toward spreading this technology.
(3) …In Hard To Reach Places and Beyond
A 3D printer and system could allow creation of useful devices and models at even hard-to-reach, remote locations. Consider rural centers, international areas, and even forward military venues. Need a prosthesis fit to your patient’s stump? Make it from a white light 3D scan and printer. Viola.
A team of Makers could easily be responsible for creating the prosthesis from imaging. It could ensure both fit and tensile strength.
Soon, Grasshopper, The Future Is Coming
Just imagine a day where a patient has a CT scan and, immediately, necessary equipment and devices are created according to their own personal requirements. As physicians, we could create everything from special use medical devices (eg ostomy appliances that fit near difficult wounds) to highly personalized cervical spine immobilization collars.
Want to take your gallstones home with you? (We can’t give them out anymore right?) Well now we can give you an awesome copy for your morbid fascination or other interest.
Who Would Pay?
Hospitals currently have add-on services such as baby photos and other fee-for-service add-ons. Perhaps 3D modeling could be another. Filaments like PLA and ABS are inexpensive, after all, and the initial costs would come, mostly, from a one-time hardware expense of less than twenty thousand dollars.
…and if the hospital couldn’t make a business model out of the direct revenue, it could definitely justify the expenditure in terms of patient satisfaction and niche marketing. After all, I would be much more content, as a patient, if a physician could show me how my spleen was injured using a model of my very own spleen. I’d like to take that home with me, and would give even higher Press-Ganey scores to hospitals that could create that model of my particular injury and send me home with it. Will that hold for most patients? I don’t know…maybe a study is in order.
Let’s consider creating a subspecialty of Makerology, where we develop a system of creating special use medical devices (we could even have an app store for the .stl files) for rural, international, or under-served areas.