Disruptive doc tops list of 50 Most Influenctial physician exces
The eighth annual Modern Healthcare/Modern Physician ranking of the 50 Most Influential Physician Executives is indicative of the transformation the healthcare industry is undergoing. A number of the names that have appeared perennially on the list are gone or moved down in the rankings (particularly those with Washington addresses), and eight new names appear this year—including Dr. Eric Topol, who debuts at No. 1 on the strength of his book, The Creative Destruction of Medicine: How the Digital Revolution Will Create Better Health Care.
While others debate arcane legal points and the philosophical slippery slopes pertaining to the Patient Protection and Affordable Care Act, Topol instead writes about how “a propitious convergence of a maturing Internet, ever-increasing bandwidth, near-ubiquitous connectivity, and remarkable miniature pocket computers in the form of mobile phones” are taking physicians and patients where no one has gone before.
Topol throws down the gauntlet immediately by opening his book with this quote by Voltaire: “Doctors prescribe medicine of which they know little, to cure disease of which they know less, in human beings of which they know nothing.” He later quotes George Orwell, who called hospitals the “antechamber to the tomb.”
“We need a jailbreak,” Topol writes. “Medicine is about to go through its biggest shakeup in history.”
Among his biggest supporters is Dave deBronkart, better known in cyberspace as “e-Patient Dave,” a former stage-four kidney-cancer patient and now a board member of the Society for Participatory Medicine. He says he likes the use of the phrase “creative destruction,” a term popularized by Austrian economist Joseph Schumpeter’s book Capitalism, Socialism and Democracy published in 1942.
“What Topol correctly identifies is that healthcare is not shattering or blowing up, but it’s being unbundled and the pieces are recombining in different ways,” says deBronkart, who made waves recently by posting on his website a request for proposals to remove the skin cancer cells from his jaw.
“He sees more clearly and precisely what’s happening—including the underlying mechanisms,” deBronkart adds. “The people who say, ‘No, no, hold back the tide’ will have an unhappy outcome.”
Topol says, at least partially because “there isn’t a pattern in medicine for acting quickly,” he structured his book more for public consumption rather than for his peers who have so far shown resistance to genomic medicine, using technology such as wearable body sensors and failing to recognize that “the most exciting time ever in the history of medicine and healthcare lies before us.”
“The idea was that, consumers—if they were educated about these possibilities—they would want them, they would drive this so much more,” Topol says. “It will be a joint partnership with physicians, healthcare systems, but hopefully, in many ways, the leading edge will be consumer because it’s the patient that has the most vital interest in his or her future health.”
What patients will realize first, according to Topol, is that they will have access to information that they never had before. This will include data on their blood pressure, glucose levels, hearth rhythm, brain waves, even information on how aspects of their genome will interact with the drugs their physicians are prescribing—and this all will be available on their smartphones.
In his book, Topol talks about the resistance to allowing patients to have access to their own healthcare data, writing that “The American Medical Association has lobbied the government hard for consumers not to have direct access to their genomic data, that this must be mediated through physicians.”
According to the AMA, however, Topol has “mischaracterized the AMA’s position on direct-to-consumer genetic testing.”
“This testing can be a valuable tool to aid in diagnostic and therapeutic decisions, and the AMA supports the rights of patients to obtain this information,” AMA President-elect Dr. Jeremy Lazarus says in an e-mail. “Because the results of genetic tests are seldom straightforward and the health conditions they address are complex, they should be done with the guidance of a physician, genetic counselor, or other genetics specialist.”
Without proper counseling, Lazarus says, patients may needlessly spend money or misinterpret test results, which could lead to making “unnecessary or unhealthy lifestyle changes.”
Others, though, are viewing Topol’s book more positively, and its preface includes words of praise from former National Institutes of Health director Dr. Elias Zerhouni,