Interview with Dr. Eric Topol (editor-in-chief of Medscape)

September 24, 2014

The editor-in-chief of Medscape, Dr. Eric Topol, visited Stanford to sit down and do an interview with our Dr. Vergese for the Medscape One-on-One online video series. During this visit I got to meet with him to ask him a few questions. Dr. Topal is a cardiologist, geneticist and researcher. He has also been a key player in wireless medicine since it began.

Dr. Ozdalga: Hi Dr. Topol, Thank you for speaking with me today. The first question I have for you is: What is your take on the new changes in technology and how it affects patient care? What are your thoughts on things we’ll see in the future regarding patient care as technology improves?

Dr. Topol: Well,  I think the biggest thing is that the tools that we’ve used to do the physical exam haven’t lost their primacy and importance, but the tools that we use now are so much more capable. So whether it’s being able to do things with a smartphone or using a pocket ultrasound, those sorts of things, it’s really revamped our approach to the exam. And it could revamp a lot of unnecessary sophisticated imaging.

The other big thing is of course the virtual contacts, and they’re really increasing exponentially. To the point that by the end of this year it’s projected one out of six doctor visits will be virtual; and that is really indicative of the shake-up that’s occurring in medicine.

So the question: We’re not really ready for virtual medicine, we’re not ready for the patients to do the physical exam and have it sent electronically. We have to gear up for that, that’s a whole different type of training and it’s going to become more commonplace. There still will always be a need for physical office visits, but these are for the more routine things like, for example, a child with an ear infection. Obviously many things can be done remotely that don’t require the physical visit.

Dr. Ozdalga: As you know Dr. Verghese and the Stanford 25’s main emphasis is not only the physical exam, but connecting with the patient. How do you feel that changes with the virtual patient? Will it affect the ability for doctors to connect with them?

Dr. Topol: Well, I think the connection will actually be exquisite, because now the patients will feel much more activated. They’re really going to be integral to this whereas before they were in another orbit. So technology can actually paradoxically bring things closer. I like to use the portable ultrasound as an example because I now show the patient their scan in real time whereas before they couldn’t even get the result! They would call and beg “what did my test show?” So to be able to show it and share it in real time is actually an intimacy. They’re still touching the patient, doing the exam, but you’re sharing very impressive information whether it be sensors or whether it be imaging, and the patient really enjoys it.

Dr. Ozdalga: Beautiful. It’s been said that the physical exam and the art of the exam is dying, and a big reason for that is because of technology. Do you agree with that?

Dr. Topol: No, I actually think the physical exam is as important as ever, but it’s just a different physical exam. It’s using technology integrated with the exam, it’s also being able to interpret physical exams that are not done physically. Some of the parts can be done by the patient. So it’s a different look but it’s more important than ever before.

Dr. Ozdalga: Thanks so much Dr. Topol, this has been really great.

– Errol Ozdalga MD
(Transcription by Serena Brown)