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Product details
File Size: 5695 KB
Print Length: 390 pages
Publisher: Basic Books (October 25, 2016)
Publication Date: October 25, 2016
Sold by: Hachette Book Group
Language: English
ASIN: B01IMZ5AQI
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Topol makes some interesting points, and I strongly agree with his central argument that patients should be the owners of their own medical data. However, Topol starts his book with a heavy handed straw man argument with his portrayal of modern medicine being shameless paternalistic - this rings false to me and distracts from his main point. Topol seems to very much dislike and distrust doctors despite the fact that he is one himself. He also applies several rare genetic medical conditions to demonstrate his rational for patients making their own medical decisions without the aid of the medical profession - his point would have been much stronger had he used examples of more common medical scenarios. Overall I learned some interesting facts about technologic advancements in medicine and genetics. This was an informative read, but the tone and clear anti doctor bias was somewhat distracting.
This is a must-read for anyone who wants to understand how quickly and dramatically health care is changing. Some would describe Eric Topol as a "futurist", but that suggests he's talking about things 10+ years away. I think of him as a "near-futurist" with a unique ability to synthesize the scientific and cultural trends emerging in different parts of the health care system, to help us see how it's about to come together.As a physician, I find this scary and exciting. As a patient, family caregiver, and advocate, I'm thrilled. The Patient Will See You Now takes us on a wonderfully written tour including: the end of paternalism in health care (hooray!), tools that patients and families now have to be partners in their care, and an approachable overview to how genomics is finally bringing us personalized medicine. That last piece is even more important to understand given Obama's recent proposal to sequence 1 million genomes.Whether you think all of these changes are good or not, Topol's work here is a huge amount of easy-to-understand education, impeccably researched, and a pleasure to read.
Topol's earlier book - The Creative Destruction of Medicine: How the Digital Revolution Will Create Better Health Care discussed quantified-self, and aspects of the app-centric health data logging and analyses and concluded that mHealth will form the basis of healthcare disruption. In this book, Topol provides a very interesting thought framework to deduce "what's next?"The first section expands his assertion that paternalistic healthcare systems (personified by FDA, AMA, and traditionalists) is really behind the times and the notion "nothing about me without me" is increasingly becoming not only feasible but also demanded by the patients. Providing a detour explaining the evolution of interpretations of the Hippocrates oath, Topol uses that opportunity to take issue (yet again) with the AMA and the entire practice around guidelines. While arguing for increased access for patient-related information to the patients, Topol clearly acknowledges the difference in information and knowledge gaps and points out that mere access is not sufficient, but it is a critical step in rethinking patient engagement and direct participation. To further expand on these themes, Topol borrows Eisentien's characterization of printing press as a change agent and draws significant parallels with that transformation and smartphones, calling this the "Gutenberg moment". While a healthy skepticism is warranted in the claims of everything from holy wars to Renaissance to modern science and founding of american republic is attributed directly to the printing press, one cannot easily dismiss the "combinatorial intellectual activity" printing facilitated. Topol argues (successfully) further that the technology already exists to enable this remarkable period of creativity in healthcare. Using relatively recent episodes such as FDA v/s 23andme and Angelina Jolie's aggressive preventive measures, Topol provides a very informative and engaging view of how the healthcare system is clearly at an inflection point.In the second section, Topol focuses primarily on the key enabling technologies that will make his vision of a democratized and personalized healthcare a reality. Moving beyond traditional logging devices, Topol paints a realistic vision of the technologies and the opportunities they are already creating such as from lab-on-a-chip to lab-in-body. Along the way, his insights on the failures of EMR systems (using OpenNotes as a contrast), potential of "pre-womb to tomb" predictive/diagnostic models is well worth the read. In fact, the chapter on the various -omics and their potential role (adapted from his famous paper in Cell) and examples on pre-diabetic and airway diseases in itself is worthy of investing in this book. A reader will also gain significant insights about some trailblazing companies like Theranos, QuantuMDx, etc. The discussion around how 3 of the 5 imaging technologies have already been miniaturized to hand-held devices is a clear indication of the realism embedded in Topol's assertions.In the third section, Topol objectively analyses the import of these changes (cultural and technological) on how healthcare will be delivered and consumed. These discussions go beyond "disintermediation of doctors" and is a must-read for anyone interested in developing new service models. A few years ago, The Innovator's Prescription: A Disruptive Solution for Health Care, provided a radically new way to rethink service models - Topol's book does the same from the viewpoint of patient and the role of technology.At times, Topol perhaps extends the patient advocacy too aggressively. For example, on a discussion crucifying Myriad and value of patents, he seem to dismiss the risk taken by private enterprises to generate these insights. While he fully acknowledges that information and knowledge gaps are critical, he uses a few hand-picked examples of how highly motivated individuals were able to be remarkably active with the diagnosis and treatment of their conditions (it is hard to say how generalizable these episodes are). Criticisms on AMA may also not be entirely fair and while there will always be "eminence-based medicine" as Topol characterizes it, there is no doubt that some of it needs to be modulated better with patient-centric approaches.With the clarity of discussion aided by well-chosen examples and analogies bereft of needless cheer-leading, over 50 pages of notes/references, excellent diagrams accompanying some of the key concepts, Topol's book is well-poised to define the next big discussion on healthcare. With the aggressive growth of wearables and smartphones showing no signs of slowing down, wider acknowledgement of patient participation as key for healthcare outcomes, changing delivery models such as ACOs in the US, some of Topol's vision may become reality sooner than even he seem to hope for. Nevertheless, Topol has succeeded in providing a clear thought framework to assess and harness the role of mobile technology in reshaping healthcare ecosystems.
Dr Topol has a vision of the future of healthcare that is probably as good as futurist ever are. Most of the time the future is not what is imagined. That should not stop anyone from trying! He sees the demise of the general hospital as we know it and more DIY medicine with the smartphone as the hub of wonderful new sensors will give ICU monitoring at home. All this would be very good if sick people were still able to always think clearly and follow their best interests. I do think he underplays to role of greed in the health care system, but my crystal ball was cracked in an unforeseen accident. This book is well researched and written.
This book aligns well with my approach to all medical services that each of us experience with the medical system here in the United States.For years I have seen myself as a "customer", not a patient and as a customer I have the same rights and requirements from the medical establish that I have with say a repair shop and repairs to my automobile.I have been over "well, the doctor said so" fairy tail for years now and any doctor that refuses to allow "my" participation in my own health care gets fired.This book lays out much of the truth of how we got in this predicament and speaks to where this is all headed.Fine reading if you have any idea of what really drives the medical establishments in the US.
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