Eric Topol’s new book explains how digital technology enables individualized health care. While the book has some flaws, it’s a reasonably good introduction to a fascinating and important topic.
The book is divided into three parts: Setting The Foundation, Capturing The Data, and The Impact of Homo Digitus. Part One begins with a familiar message: the Internet and digital technology are changing everything. The next chapter reveals that many accepted medical practices are based on questionable research findings. Part One ends by discussing how consumers are sometimes misled by modern medicine—and may be misleading themselves about alternative medicine. The overall message is that the current system often causes as much harm as good, but not to worry, help is on the way.
Part Two describes new ways of harvesting health data. It’s unfortunate that Topol doesn’t cover some of the technologies in more depth. It’s even more unfortunate that he doesn’t display the same skepticism as in Part One. For example, he talks about putting sensors in automobiles to monitor the driver’s health, with the possibility of asking the driver to pull over or even automatically shutting down the car’s ignition system. If the lesson of Part One is that the current system can be hazardous to your health, the message of Part Two seems to be that the new technology merits blind trust.
Part Three argues that the U.S. health care system is too conservative and unaccountable, and how that’s about to change. As the author of a book about the history of medical technology, I can’t agree with Dr. Topol’s diagnosis. There is overwhelming evidence that new technology has repeatedly and dramatically changed our health care system. But it’s good to know that the medical profession resists change just for the sake of change. And if we want doctors and hospitals to be more accountable, then we need to start comparison shopping. Make them compete for our business, and do our own research on the Internet.
I have two major problems with Topol’s book. How could a proponent of individualized health care be so oblivious to the elephant in the room? The Patient Protection and Affordable Care Act will make our health care system more centralized, more top-down, and more bureaucratic. That doesn’t lead to individualized health care—it leads to one-size-fits-all health care.
The other problem is that the book is brimming with clichés. In fairness, Topol warns in the title that this is a book about “creative destruction” (if not “the democratization of medicine”). This is more than just annoying, however. For example, Topol pays obligatory homage to “crowdsourcing.” In my opinion, the “wisdom of crowds” is an oxymoron. According to a popular anecdote, when a large number of fair-goers were asked to guess the weight of an ox, their individual guesses were wrong but the average guess was remarkably accurate. Sorry, but this does not show that crowds possess wisdom. It merely illustrates how people’s false judgments are sometimes evenly distributed around the truth.
Topol boasts that in 2011 he tweeted: “Tunisia… Egypt… American medicine?” Last I heard, Egypt was on the verge of handing power over to the bigoted and anti-democratic Muslim Brotherhood. And a year after the Tunisian revolution, there are reports of journalists being arrested.
Topol’s book contains many interesting ideas and facts. And I’m sure it’s an accurate reflection of what many digital health care entrepreneurs are thinking. But the “Arab spring” is not a good model for health care reform. Not by a longshot.
Tuesday, February 21. 2012
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