Hi-Tech Comes to Family Practice

Family practice has a reputation for being a low-tech, hands-on specialty. But speaking in a keynote address at the American Academy of Family Physicians Assembly Oct. 26 , Eric Topol, MD told his audience they would do well to use more technologically sophisticated devices.

Topol said e-tools like a smart phone device that patients can use to make their own echocardiograms,glucose monitors that uses the same approach,and new Apple products that track blood pressure through earbuds worn by the patient, have made the basic tools of family practice obsolete.

Topol is director of the Scripps Translational Science Institute in La Jolla, CA and chief academic officer for Scripps Health.

He called the stethoscope “a relic” and illustrated that by using his phone to take his own ECG and project it for the audience to see.

“Why would you use that [stethoscope] when you could see everything in seconds,” he asked.

Topol, author of the forthcoming “The Patient Will See You Now: The Future of Medicine Is in Your Hands” is a strong believer in technology’s future.

He predicts an ongoing revolution in diagnostic devices that can be used by the patient--like those that attach to smart phones--will transform the practice not only of family medicine but cardiology, oncology, and some other specialties too. Their use will also have the potential to cut medical costs dramatically.

Instead of having to make an office visit for an ECG, a patient can phone it in.

Also in the works, Topol said, are patient-held devices to gauge lung function and diagnose cancer, creating electronic records that could then be smart-phoned in to a physician.

The basic principle appears to be that anything that can be scanned or photographed can be turned into a part of a diagnostic record by the patient.

The short list of devices in the pipeline, as compiled by AAFP’s news staff, includes a remote heart failure monitor that a patient can wear, an ICU vital signs monitor that fits on a patients wrist, an app that can accurately diagnose skin lesions, and even an app that can tell a patient whether a bone is broken.

Not all the devices are strictly non-invasive. Topol told his listeners of a process coming to market that will use a single drop of blood to perform tests faster and cheaper than those done in hospital laboratories. It’s in development at Theranos, another Palo Alto company.

But already there is some blow-back from traditional doctors. Commenting on the AAFP's account, one poster wrote "Gadgets are sexy, but they do not replace basic examination skills." Said another "If cost is a concern, it's hard to beat the value of a stethoscope" and it "never freezes up."