Dr. Eric Topol’s credible and thought-provoking comments on the over-use of stents appeared in entries in this blog in August 2006 and in December 2006.
(p. A15) “The U.S. government has been preoccupied with health care ‘reform,’ but this refers to improving access and insurance coverage and has little or nothing to do with innovation,” even though, as Dr. Topol notes, adopting new approaches would improve care and lower costs. . . .
. . .
“The Creative Destruction of Medicine”–an allusion to economist Joseph Schumpeter’s description of “creative destruction” as an engine of business innovation–is a venture capitalist’s delight, describing dozens of medical technologies that show great promise. The book also provides colorful anecdotes about Dr. Topol’s own sampling of these products, as both a doctor and stand-in patient.
. . .
. . . , full adoption of the new tools will require the Food and Drug Administration to alter the way it evaluates products. The FDA, he says, should allow the testing of drugs on patients who are selected for their prospect of deriving a benefit. Right now, the FDA usually requires drugs to be tested in a scattershot fashion on large populations. With drugs being tested on cancer patients, he notes, the “FDA insists on a body count to be able to quantify how much and how long the new drug improves survival”–even though diagnostic markers can sometimes reveal in advance which patients are unlikely to gain a benefit.
Dr. Topol worries that doctors will resist technologies that empower patients because the tools will also diminish the doctors’ gatekeeper role. The American Medical Association, for example, battled firms that provide genetic information directly to patients. “This arrangement ultimately appears untenable,” the author writes, “and eventually there will need to be full democratization of DNA for medicine to be transformed.”
For the full review, see:
SCOTT GOTTLIEB. “BOOKSHELF; Digital Doctoring; It’s hard to fake sleep to avoid your spouse’s bedtime chatter when a ‘Zeo clock’ is displaying your real-time brain waves.” The Wall Street Journal (Fri., February 3, 2012): A15.
(Note: ellipses added.)
(Note: the online version of the review has the title “BOOKSHELF; Digital Doctoring; The digital revolution can spur unprecedented advances in the medical sciences, argues Eric Topol in “The Creative Destruction of Medicine”.”)
The book under review is:
Topol, Eric. The Creative Destruction of Medicine: How the Digital Revolution Will Create Better Health Care. New York: Basic Books, 2012.