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Deep Medicine

How Artificial Intelligence Can Make Healthcare Human Again

By Eric Topol
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Deep Medicine by Eric Topol

Deep Medicine (2019) explores how artificial intelligence could dramatically reshape the health-care industry, from how illnesses are diagnosed to the ways patients are cared for. Our current experience of care is “shallow,” as overworked clinicians rush through patients without truly empathizing, listening, or being present. Artificial intelligence has the power to change this – and, perhaps paradoxically, to bring the human side back to medicine.

Key idea 1 of 9

Health care requires a shift from shallow medicine to deep medicine.

Robert was a fairly healthy 56-year-old. But one afternoon, he experienced what doctors call a “ministroke” – his face went numb, and he began having trouble seeing. His doctor told him to continue taking an aspirin every day, as he had been before. Unsatisfied with this prescription, Robert went to see a neurologist, who then referred him to a cardiologist. That’s when he found out that he had a patent foramen ovale, or PFO, a tiny hole in the wall separating two of his heart’s chambers.

The cardiologist claimed that this condition was the cause of Robert’s ministroke, and that he needed surgery to close the gap in his heart. But Robert wasn’t so sure.

The key message here is: Health care requires a shift from shallow medicine to deep medicine.

After seeing the first cardiologist, Robert came to see the author, Eric Topol – also a cardiologist – for a second opinion. Topol was shocked by the original assessment; one in five adults have PFO, and the condition isn’t connected to strokes. So he and Robert worked together to determine Robert’s real issue and found it was atrial fibrillation, which can be treated with a simple blood thinner.

Robert’s situation exemplifies what Topol calls shallow medicine, in which burned-out, depressed doctors don’t take the time to develop real connections with their patients and make holistic assessments.

Average clinic visits in the United States, for instance, last just seven minutes. Perhaps as a result, there are about 12 million significant misdiagnoses per year across the country, and up to one-third of medical operations performed are unnecessary. 

Patients are suffering, but so are the people who treat them. One in four young physicians experiences depression, and almost half of American doctors today have symptoms of burnout. This condition greatly increases the risk of medical errors – and even leads to physician suicides. 

To address these issues, we must start the shift from shallow medicine to deep medicine. This shift occurs in three fundamental ways. First, medicine will require physicians to deeply define each individual with as much of their relevant personal and health history as possible. Second, it will require deep learning on the part of artificial intelligence, to augment doctors’ diagnostic abilities and automate repetitive tasks. And finally, deep medicine will require doctors to practice deep empathy – seeing patients as real people, not just as problems to be diagnosed.

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