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Noteworthy new books by Eric Topol and Otis Brawley/Paul Goldberg

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Dr. Eric Topol, director of the Scripps Translational Science Institute, excerpts his new book, The Creative Destruction of Medicine: How the Digital Revolution Will Create Better Health Care on the website of Scientific American.

“problems confront anyone trying to navigate all the medical procedures, operations, prescription medications, vitamins, supplements, herbs, alternative treatments, over-the-counter products, and home devices that confront them. The key to the problem is an empowered, knowledgeable patient, but, as we shall see, extra information need not lead to empowerment. Whether information is pushed to consumers (by the news media or by direct-to-consumer advertising) or pulled out of the system by consumers themselves (by, for example, visiting Google Scholar or a social-networking site developed for sufferers of a particular disease), if a consumer can’t make the best, most intelligent use of it, all sorts of trouble can unfold.”

There’s a review in the Boston Globe of the new book, “How We Do Harm: A Doctor Breaks Ranks About Being Sick in America,” by Dr. Otis Brawley of the American Cancer Society and Paul Goldberg of The Cancer Letter. Excerpt:

“Brawley’s sense of outrage is palpable, and he makes clear what his purpose was in writing this book: “I am not especially concerned about the rationing of health care. I am more concerned about something else entirely: rational use of health care.” He continues: “Poor Americans consume too little health care, especially preventive health care. Other Americans – often rich Americans – consume too much health care, often unwisely, and sometimes to their detriment.” And elsewhere: “[M]y hope [is] that a genuine popular movement will form to make medicine accessible, driven by science, and trustworthy . . . nothing short of another civil rights movement will do . . . [civil] rights are important, but the right to equality in health care is no less important, and it has been left behind.”

Brawley also focuses attention on the quality of care delivered to Americans fortunate to have health insurance and finds it lacking. One example involves recommendations for aggressive screening for early forms of cancer that lead not only to huge expense, but also to excessive and unnecessary radiation exposure and surgery in patients who would have died with, and not of, their disease.

I came away from this book sharing Brawley’s frustration and agreeing with much of his basic outlook on how medicine should be practiced. He reminds the reader that “[o]ne of the greatest honors a human being can bestow upon another is to say, ‘Can you help me?’ ”; and that doing just that while first doing no harm continue to be at the core of good medical practice.”


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