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Shifting the Power Balance From Doctor to Patient

Dr. Eric Topol (right) at a New York Times health care conference. Photograph by Michael Loccisano 2014—via Getty Images

I talk a lot about revolution in this space. (That’s a healthcare revolution for those just joining us. Put those pitchforks down, please.) But for the most part, I have focused on technological upheaval: how the extraordinary tools and platforms of the digital age are feverishly disrupting the way we do virtually everything in our pursuit of well-being—an effort, mind you, that in 2015 cost the U.S. alone $3.2 trillion, or $9,990 per person.

But the breakthroughs in health-tech—advances that, in theory at least, should make essential care more accessible to and cheaper for both consumers and providers—is only part of the transformation now underway. Indeed, it may be the least revolutionary part.

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A more tectonic—or “tech-tonic”—frameshift, as Dr. Eric Topol writes, is what’s happening to the patient-doctor relationship: The power is fast migrating from the “paternalistic,” information-controlling healthcare provider (for shorthand, “the doctor”) to the consumer who is paying for that care and information, and who needs it most—and importantly, who, once empowered and trained, can best manage it.

That is the critically important message of Topol’s masterfully argued 2015 manifesto, The Patient Will See You Now—which, I’m ashamed to say, I only began reading (and finished) yesterday.

I have known Topol—a professor of genomics and chair of innovative medicine at the Scripps Research Institute, founder and director of the Scripps Translational Science Institute, and a respected cardiologist to boot—for some time. His seminal 2012 book on the digital health revolution, The Creative Destruction of Medicine, predicted much of what has come since. And I have been avidly following the man’s posts and commentary on the subject for years. (If you haven’t, you should.) So, for the life of me, I don’t know how I missed The Patient Will See You Now.

That said, reading the book two years after publication, it’s clear that Topol’s driving thesis is dead-on. The ability to move information and data instantly, from anywhere to anywhere, has already shifted the balance of power from service providers to consumers in nearly every industry—retail, publishing, travel, finance, and so on. But for years a deeply ingrained medical paternalism slowed that trend from happening in healthcare. Now, as if a dam has broken, that change is rushing forth in a deluge, Topol shows. And he illustrates it with a stream of compelling anecdotes, eye-catching data, and no small amount of instructive history.

It’s not just the steady march of technology that’s propelling this transfer of power. It’s also a brigade of courageous, enterprising patients themselves who are making the most of that tech—from innovative smartphone apps to social media to online genomic databases to telemedicine.

The sum effect, writes Topol, is nothing short of transformative:

“When each individual owns and takes part in generating their entire set of medical data and information, including records, notes, labs, images, omics, sensors; when they have complete assurance of privacy and security, such that their identity will not be revealed and their data will not be sold or misused; when individuals become fully respected by their doctors and on an equal footing; when the individual now unabashedly asks the right questions, drives the process, and makes the choices; when individuals have full access to the cloud, supercomputing, and telemedicine, and there is total transparency for data on doctors and hospitals with respect to outcomes, costs, and ratings; when it is for all ordinary people, anywhere in the world. When all that is true, we’re not just talking medical empowerment. We’re talking medical emancipation.”

Okay, fine. Go ahead and grab your pitchfork!

This essay appears in today’s edition of the Fortune Brainstorm Health Daily. Get it delivered straight to your inbox.

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