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Format: Paperback, Illustrated
Description
The essential guide to how digital technology enables all of us to take charge of our health “Dr. Topol’s vision is compelling, combining an empowering view of technology with the recognition that medicine requires something more.”―Wall Street Journal A trip to the doctor is almost a guarantee of misery: you make an appointment months in advance, wait for several hours when you arrive, talk to a doctor for fifteen minutes, then wait longer for lab tests, the results of which you’ll likely never see unless they indicate more invasive tests are needed, most of which will probably prove unnecessary—and your bill will be astronomical. In The Patient Will See You Now, Eric Topol, one of the nation’s top physicians, shows why medicine does not have to be that way. Medicine is in what Topol calls its “Gutenberg moment.” Much as the printing press took learning out of the hands of a priestly class, the mobile internet is doing the same for medicine, giving us unprecedented control over our healthcare. With smartphones in hand, we are no longer beholden to an impersonal and paternalistic system in which “doctor knows best.” Medicine has been digitized, Topol argues; now it will be democratized. Provocative and engrossing, The Patient Will See You Now is essential reading for anyone who thinks they deserve better health care. That is, for all of us. Read more
Publisher : Basic Books
Publication date : October 25, 2016
Edition : Illustrated
Language : English
Print length : 384 pages
ISBN-10 : 0465040020
ISBN-13 : 25
Item Weight : 13.6 ounces
Dimensions : 5.63 x 1.25 x 8.38 inches
Best Sellers Rank: #271,443 in Books (See Top 100 in Books) #7 in Diet Therapy (Books) #12 in Health Risk Assessment (Books)
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Top Amazon Reviews
Format: Hardcover
Dr. Topol's latest book on health care is better than his most recent one,"the creative destruction of medicine", which I bought and gave to many friends. The computer rule, "Moore's law" works in in medical computer science and Topol discusses many of the great and rapid changes in devices and use of computer and cloud in detail and understandable to laypersons. First, he is an advocate for quality electronic records and the ability for patients to access their records and contribute to them. I have spent lots of time in working on medical records and have moved from the concept of Lawrence Weed that medical records are designed for communication with health care providers and in his SOAP concept to help all users work in designing plans based on data. Now we want data accessible to patients and even more their ability to order, pay for and get lab data on their own. An electronic medical record should outline the issues or problems a patient has and what assessment and plan for treatment considered. An electronic medical record should be available on the cloud to the patient on a password protected site. Our ability as patients to carry our own data and get data including genomic, are important as we consult with physicians to plan for the best path to wellness. In his prior book he discussed the use of I Pad kind of small computers to carry texts, charts, illustrations as needed in medical,school. Three-dimensional drawings and dissections can be very important for physicians in training as they learn the subtle relations between anatomical parts. My experience with palm pilots years ago when on "rounds" and I asked a question about the diagnostic criteria for an uncommon spinal disorder. I noted a young fellow off to,the side punching his finger in his lap area, and soon he had the answer: not retrieved from his cortex but from his mini computer which then had lots of lists. Now the ability of physician and student or patient to access information is unbelievable. Topol talks about smart phones and their use in diagnosis. One is in the smart phone otoscope app. It has use for patients who can send the image of their child's ear drum to a site where it can be evaluated. Months ago my daughter brought our grand daughter to her pediatrician where he not only used the app to show mom and child the ear but uploaded normal pictures to discuss the diagnosis. Perhaps of more importance are the cardiac diagnostic capabilities. Rhythm strips can be run from your bedroom if you feel your heart rate accelerating. The ecg is read and diagnosed as pathological or requiring assistance with quick computer read outs and transmission of the rhythm strip to your cardiologist for his/her review. Physicians can use an ultrasonic heart sound monitor, first mentioned in Topol's prior book but shown at a conference I attended where Abraham Verghese was a key speaker. He noted that the stethoscope is now archaic and with the use of the electronic device an average auscultater can appear knowledgeable. In my experience as young students round with a teaching cardiologist, the guru will ask all to listen to his patient to hear the murmur and then tell them it is a grade 2 mitral ejection murmur or some other heart sound. All students nod that yes they heard and understand. Most did not. Years ago we had friends who had a neighbor who was scheduled to enter college with a scholarship in swimming. His pediatrician on the pre college physical said he had a murmur and sent him for further testing. Parents were upset. How could that be, the boy is a strong healthy athlete? His diagnosis was correct, the youth had IHSS a rare narrowing of the exiting heart vessel, one linked to sudden death in otherwise healthy athletes. Most generalists would have missed. With the electronic ultrasonic auscultation device it would have been obvious. Of course older internists insist on the effectiveness of the stethoscope, Verghese describes the stethoscope as a shaman's object, one to inspire the patient with confidence. Why else would physicians running for political office wear one when campaigning if not for the symbolic value. Topol mentions that outstanding senior cardiologists believe that electronic device is nowhere as useful as a stethoscope. Physicians are not Luddites; we do dislike change. Topol is self assured and not wary of criticism, which he treats lightly and with good humor. He has no trouble standing up for what he believes are sound principles. His discovery of unreported findings of cardiac risk from certain medications changed his career as not only industry but a medical edifice got very upset. More people need to have the courage to explain what medical research means. As a scientist in genomic studies at the Scripps institute his discussion of the 'omes is full. In his last book the chapters on the genomic aspects of health care were difficult to follow for those of us older folks where genetics ended with beans and flies. This new volume is far easier to follow although the issues are more complex. The NYT had an article on neuroscience studies where the author noted there are so many 'omes that there are now a group of anti-omes.( NYT Magazine, 11Jan,2015' p.29, "Mind Games, by Gareth Cook) It would be easy to join that group of deniers. Many chapters discuss the use of genomic testing today and what it may be in the future. Important concepts for all of us. The longest is "Angelina Jolie : my choice". Her choice involved not just her ability and right to review the risks of carrying the BRCA gene but the courage to discuss it widely. This allows Topol to suggest that genomic studies might best be in the hands of patients. He also shows how Kim Goodsell was able to research her own genetic disorder and discover changes in an uncommon disease through online study. Discussion of eminent physicians and the paternalistic” eminence” based discussions and advice as well as the “edifice” based method of dispensing care are equally essential for us to fathom as we move ahead and the costs of medical care rise so quickly as we search together for the best care for all. I highly recommend this for all thinking people. Most of my peers recall the Nobel prize for the double helix was awarded long after we had completed basic biology. The rate of growth of know,edge and use of current biological science is so fast to be overwhelming. Any who think about health care and are bothered because so much is happening should realize that in a democracy we all need to help our elected officials look into the future and help us arrive at a point where we all are involved and all understand our own health and the care it needs.
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Reviewed in the United States on January 16, 2015 by Richard Scott
This is an interesting book if you are interested in how technology is changing healthcare and putting the power back into the hands of the patient. The book is filled with examples of digital innovation like wearables, cell phone apps, and open information systems that are changing the present and future of healthcare as we know it by giving patients control of their information. Despite the forward thinking premise, it is clear this book was not written by a full-time writer and can be a struggle to get through. The message of 'paternalistic' control by doctors vs patient control of their own information gets repetitive even if you agree with the premise, which I do. If you can get past these relatively minor flaws, and have genuine interest in the future of healthcare, then you will find many things in this book that will spark your curiosity and excite you about the future. Dr. Topol deserves a lot of credit and recognition for criticizing doctor control over the healthcare system, while he in fact is one. It's not easy to rail against a system that helps maintain your job and well being. This book will give you renewed optimism for the future of healthcare, which is no small feat considering the overwhelming bad news you hear from politicians and the media. I hope Dr. Topol is right on this one.
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Reviewed in the United States on January 19, 2016 by Alex Kane
Format: Hardcover
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.
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Reviewed in the United States on December 28, 2014 by Jijnasu Forever
Toole is a skilled wordsmith, a gifted craftsman, an author who manages to popularize difficult topics and bring out in a form that lets even the non expert have an expert's view. Would you like a few and wonderful sound bites from the first section (of three, that's as far as I've got on my flight home this afternoon)? "No longer will MD stand for medical deity." Or, "...smart, hyperconnected patients represent a serious challenge to medical paternalism." Of course, that's what these are, just sound bites. Still, the author's hiding a treasury of gemstones in the open, a knowledge that we as patients need to have, and he has refrained from making the book unreadable just to look more intelligent, seem more scholarly, too his peers. I can't help but love it, both it's content and form. There's no style over substance here. There's no war between Wilson and House. Just and excellent mixture between truisms and truths. Just the way we normally intelligent but quite un-medical human beings need to have it. Now, have a look at a few more of the gems just from the opening pages. Then download your own copy on to you Kindle or iPad and go hunting for more gems, as well as profound epiphanies that Toole elaborates over pages. “Every patient is an expert in their own chosen field, namely themselves and their own life.” Or, “...doctors consider themselves the most evolved of the human species.” "...the power of the people is greater than the people in power.” "...we’re not just talking medical empowerment. We’re talking medical emancipation." And, if you didn't catch me at the beginning; yes, I am indeed only a patient, trying to manage my own life and not so much my death sentence. Time to take on the paternalistic tendencies of medicine. We no longer need Eminence-Based Medicine; we need EVIDENCE based medicine. Options, not opinions. Let Eric Topol lead you on that venture.
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Reviewed in the United States on May 22, 2017 by Victor Skimmeland
Format: Hardcover
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.
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Reviewed in the United States on February 5, 2016 by Zuz
I just finished “The Patient Will See You Know” which I found fascinating. I hope change in the areas he discuss accelerates and that I will see many of these things in my lifetime. It is wonderful to see a Doctor who is looking for ways to increase the power of patients. He spends a great deal of time writing about how patient generated health data will be dramatically increasing. I have some ideas about how this data should be used and protected. Here is a summary of my ideas. I have a few thoughts about how I would like to see individual data aggregated and used. I am concerned about privacy but would gladly submit any data I had provided there was a secure method to make sure the data was anonymous to data users. Users of anonymized data must make what they learn available. In exchange for using the massive amount of anonymous data, companies, individuals, researchers, etc. who want access to the data must agree that anything they learn using the data must be made available to the data manager in a manner that will be able to be tied to all the individual elements in the database which people have contributed and have been shown to be important in a particular study, analysis, or result. Currently there is a lot of study data on medicines that never see the light of day. See “Bad Pharma: How Drug Companies Mislead Doctors and Harm Patients” by Ben Goldacre. http://www.amazon.com/Bad-Pharma-Companies-Mislead-Patients/dp/0865478007/ref=tmm_hrd_title_0?ie=UTF8&qid=1425416197&sr=1-1. This is why anyone discovering something using the database must make the results available. Results of studies or analyses using the data must be provided to those to whom it is relevant As the database accumulates studies/results information a report should be run which tie results to people who have particular characteristics in the database. Then in a secure fashion a secure personalizer report needs to be run that ties the results to individuals who would benefit from the new information. These individuals need to be notified in some manner and here is where medical expertise comes in. When people are notified of something that may harm them they or help them they need to receive the information in a manner that allows them to both be informed and provides them with alternative actions to best use the information. To do some of the analysis of massive amounts of data Distributed Computing may be of value The following is taken from the website shown below. “The idea of distributed computing is a very simple concept. Various research projects work with huge volumes of data and computations that need to be processed and analyzed using particular algorithms determined by the research goals. In order to reduce the time it takes to process raw data, scientists have turned to the distributed computing model in which those computations are broken into components and distributed to distributed computer systems where the CPU of each system works on a computational task and then sends it back to the central server.” http://www.makeuseof.com/tag/10-ways-to-donate-your-cpu-time-to-science/
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Reviewed in the United States on March 5, 2015 by Kenneth Dzugan
Format: Hardcover
This book provides valuable information on monitoring your health and researching your medical issues. It also gives an interesting view of new medical discoveries, and new medical devices--some of which you can buy cheaply and sync with your smart phone (i.e. a cardiac monitor). In parts, the book is highly technical--and not recommended as an easy read. In general, my book club enjoyed the book--although some people skipped the "denser" pages.
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Reviewed in the United States on February 27, 2018 by sandra
Format: Hardcover
Review of Eric Topol’s The Patient Will See You Now: the future of medicine is in your hands, by Jerry Woolpy Twenty-five hundred years ago Hippocrates, the father of medical paternalism, taught that physicians should conceal most things from the patient including the patient’s future or present condition. But last year Richard Smith, Editor of the British Medical Journal, wrote that “the relationship between doctors and patients will surely be much more equal; indeed, health will be the business primarily of patients, with doctors as advisers, guides, and facilitators. Much of medical practice will be conducted online, with online consultations routine.” Eric Topol explains how, with smart phones and the internet, we will realize Smith’s prognostication. The internet makes it possible for everyone to access the medical literature, the gist of which is understandable and useful to laypersons. And it facilitates the sharing of information among patients. When patients own and control their own medical histories and can offer them to big data pools for analysis, diagnosis will improve and early detection and prevention will be enhanced. Smart phones from home will be used for lab tests and treatments can be administered there more comfortably, safer, and effectively with little or no recourse to hospitals. Surveys have already shown that the public can deal with their infirmities rationally and that even the prospect of a dread disease can be faced without panic. Almost everyone will be well served by a change that will minimize health care costs and meet the forecasted shortage of medical professionals under the present system with the more efficient electronic spread of medical talent across the world. In order to bring this about, we must overcome the domination of government by profit making corporations that thrive on the present system. We must convince large employers who insure their workers at considerable cost that they could save millions by these revisions. Meanwhile, we need to convince physicians, who as a group take an average of seventeen years to adopt innovations, to see the merits of the democratization of medicine.
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Reviewed in the United States on March 6, 2015 by Tara Woolpy