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Basic Books

The Patient Will See You Now: The Future of Medicine Is in Your Hands

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Arrives Wednesday, Nov 27
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Format: Paperback, Illustrated


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The essential guide by one of America's leading doctors to how digital technology enables all of us to take charge of our health A trip to the doctor is almost a guarantee of misery. You'll make an appointment months in advance. You'll probably wait for several hours until you hear "the doctor will see you now"-but only for fifteen minutes! Then you'll wait even longer for lab tests, the results of which you'll likely never see, unless they indicate further (and more invasive) tests, most of which will probably prove unnecessary (much like physicals themselves). 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. Instead, you could use your smartphone to get rapid test results from one drop of blood, monitor your vital signs both day and night, and use an artificially intelligent algorithm to receive a diagnosis without having to see a doctor, all at a small fraction of the cost imposed by our modern healthcare system. The change is powered by what Topol calls medicine's "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. Computers will replace physicians for many diagnostic tasks, citizen science will give rise to citizen medicine, and enormous data sets will give us new means to attack conditions that have long been incurable. Massive, open, online medicine, where diagnostics are done by Facebook-like comparisons of medical profiles, will enable real-time, real-world research on massive populations. There's no doubt the path forward will be complicated: the medical establishment will resist these changes, and digitized medicine inevitably raises serious issues surrounding privacy. Nevertheless, the result-better, cheaper, and more human health care-will be worth it. 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; Illustrated edition (October 25, 2016)


Language ‏ : ‎ English


Paperback ‏ : ‎ 384 pages


ISBN-10 ‏ : ‎ 0465040020


ISBN-13 ‏ : ‎ 25


Item Weight ‏ : ‎ 12 ounces


Dimensions ‏ : ‎ 5.63 x 1.25 x 8.38 inches


Best Sellers Rank: #328,208 in Books (See Top 100 in Books) #66 in Medical Informatics (Books) #163 in Family Practice Medicine #404 in Health Care Delivery (Books)


#66 in Medical Informatics (Books):


#163 in Family Practice Medicine:


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Top Amazon Reviews

    • Important Read
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. ... show more
Reviewed in the United States 🇺🇸 on January 16, 2015 by Richard Scott
    • Nothing about me without me - rethinking healthcare consumption 4.5*
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. ... show more
Reviewed in the United States 🇺🇸 on December 28, 2014 by Jijnasu Forever

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