Customer Reviews

The Edge of Medicine: The Technology That Will Change Our Lives

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I heard this guy on Terry Gross & Marty Moss-Coane. He was awesome. They don't make doctors like that anymore. At least I can't find them. I got a copy of the book from my husband and read it straight through. If you are interested in how technology is shaping the technical and human side of medicine, you will love this book. It's not often you run across someone who can relate Hypocrates to telemedicine.

The Edge of Medicine employs a rich symphony of details only a medical school professor could author. This is a great book for medical professional and lay-person alike. The concepts featured, from personal diagnostics to regenerative medicine, are introduced in a way for the reader to understand current clinical context and the vision of future healthcare delivery.

However, the technologies reported on are not new. These innovations have been in practice, albeit under the radar, for the last 3-5 years. In the coming years, they will form a new layer of "standard of care" demand. For instance, an Army Medical Hospital that treats soldier wounds with a regenerative medicine resolution will do the same for a civilian auto accident survivor. Little by little, what is offered as cutting edge to one group will soon be offered to another. Yet, hospital system economics will dictate care delivery based on ability to pay. More and more, we will see standard of care and affordability barrier trajectories go up in a direct relationship. Those who want to read more about the upcoming disparities in futuristic medicine should read Joel Garreau's book, Radical Evolution.

The adoption curve's economic dilemma is examined further.

The author accurately portrays stakeholder intent in the cost of healthcare: the provider and insurer want to maximize revenues. This means costs are maximized for payers. The payer is the only stakeholder that wants to reduce their costs. What does this mean for the adoption of life saving and cost saving products and services? Providers employ a competitive advantage by advertising a - high quality, low error, reduced pain, and reduced time of stay - patient solution. They are delivering better technologies to stay out in front of patient demand. They don't do so because it's a cheaper way to go in terms of investment dollars. Take robotic surgery, for example. It is not less expensive to deliver this type of care. However, hospital systems advertise client testimonials telling of the satisfaction of quick recovery and painless intervention. They bank on higher utilization of the services rendered. This provides cost justification for the technological implementation.

In the last few years, business model innovation in healthcare has moved to target the payers - those who will pay out-of-pocket for premium or simplified services. From elective surgery providers to online health communities and retail care clinics, these offerings bypass the hospital provider and insurer financial model. The one exception is retail care clinics, wherein, some insurers cover most costs of a visit (<$100). These companies get it. They reject the inelastic economics of delivering innovative care through the hospital system and insurance conundrum, replete with regulatory, reimbursement, and policy challenges. Jeff C. Goldsmith's, Digital Medicine: Implications for Healthcare Leaders, examines payer-centric business models of the future and how they will become commonplace.

The Edge of Medicine induces hope for recipients of life saving and enhancing technologies. However, this is a standard that not all American's will realize, except for what is delivered in emergency rooms of the nation.

Radical Evolution: The Promise and Peril of Enhancing Our Minds, Our Bodies -- and What It Means to Be Human

Digital Medicine: Implications for Healthcare Leaders (Management Series (Ann Arbor, Mich.).)

There is nothing in the twenty-first century that is uninteresting, and after finishing this book the opinion that this is the best time to be alive is reinforced. The advances in medicine that were predicted to occur just a decade ago have proven to be a gross underestimate, as this book clearly shows. Its author is a physician, and also has the virtue of being a technophiliac, but the best part of his writing is his frankness in assessing some of the issues in modern medicine. Treatment modalities, surgical techniques, diagnostics, and prognostics are now more than ever being done with the assistance of technology, some of this technology being highly sophisticated and intelligent.

Genetic engineering, artificial intelligence, cognitive neuroscience, robotic surgery: these are some of the tools of twenty-first century medicine. The author details the use of some of them in the book, and it is amazing to think of just a short time ago they were viewed as purely science fiction. In fact what is being done now and in a few years makes the Hollywood imagination seem sophomoric by comparison.

The author though also goes beyond a mere reporting of technological facts, for he exposes some of the finagling and politics in hospitals in the United States. One example that particularly stands out is his opinion on the "successful" hospital, these being characterized by their collection of "certificates of excellence." They acquire these by what he refers to as the "parasitic" certifying organizations that arbitrarily define novel measures of excellence, and proceed to convince hospitals, through marketing or regulatory pressure, to conform to the artificial standards that they have created. This is a story that is repeated in other professions also, where "certifying" organizations survive only by false pretenses, by asserting that quality exists in a particular business without any justification as to why their measure of quality is better than others.

For those readers such as this reviewer that are not in the medical profession but have worked as analysts or developers perfecting some of the technology that is used by physicians, the author gives some very interesting anecdotes on everyday practice, particularly in surgery rooms. Some of what the author reports can rattle the unsuspecting reader. Indeed, it many instances it is very disconcerting to discover to what degree the surgery room and its personnel are "on the edge."

One can only imagine what things will be like in medicine a decade from now, due mostly in part to technological advances. But cognizance must also be made, and the author of this book does so, to the rising costs of healthcare. Regulatory and governmental agencies will no doubt result in challenging tradeoff issues in the years to come. But with personalized genomic medicine, automated surgery, networked diagnostics, and more data transparency it is likely that the future of medicine will be an exciting one, and one that every living individual hopefully will be participating in.

A discussion for the layman about the cutting edge of medical technologies and their various future ramifications; the last chapter focuses on the most elemental technological tool - the human hand (actually the author's father's hand who was also a doctor), which puts the conflict of the entire profession of health care in a humane and sympathetic historical perspective

An exceptionally readable and short book on the technological advances occurring in medicine, in particular in biotechnology and genetics, robotics, and nuclear medicine, that will have a significant impact on how we diagnose and treat disease in the 21st century.

Dr. William Hanson is a practicing physician and technophile at the University of Pennsylvania who writes in a tone that any patient desires of their personal physician: direct, honest, and reasonable.

An excellent book for anyone interested in the future of medicine.

Hanson is a fine popular science writer. He has a gift for explaining complex ideas, often using vivid analogies, and a good sense of humor. He is evidently also a great doctor, and his anecdotes add a lot to the book. Interestingly, it is an anecdote about his doctor father and a long time patient which grabs at your heart.

The book is not very long, and in fact Hanson could easily have made it even shorter. It is better when an author has too much material. On the other hand, there was a discussion of lupus which had little justification for being included, but which interested me very much, so perhaps there is other material which I did not find compelling, but another reader may.