I recently had the chance to speak with Dr. Eric Topol, director of the Scripps Translational Science Institute, a National Institutes of Health funded program of the Clinical and Translational Science Award (CTSA) Consortium, in advance of his speaking at CHI’s July program, An Evening with Thought Leaders, being held on Thursday, July 23, at the Lodge at Torrey Pines, at 6 p.m. Topol describes below how he envisions the future of healthcare with the dawn of personalized medicine, he describes some of the research being done at Scripps to improve the practice of medicine, as well as what he finds the most rewarding as a researcher, physician and husband and father.
Q: How will personalized medicine change the practice of medicine in the coming years?
A: It’ll be a complete reboot, control/alt delete, of how we practice medicine because today we practice for a population model rather than an individual model. The way we administer therapies is to give the same drug in the same dose to all people without knowledge of the individual’s actual biology or their genetics. So personalized medicine is really a completely different mind set and base for how medicine is practiced. It will be much more preventive than ever.
Q: What is the most important contribution personalized medicine will make to the practice of medicine?
A: The largest contribution will be promoting efficiency. Today, we have a lot of patients who are taking the wrong medicine at the wrong doses, being given the wrong devices, because of this mismatch of what we do for patients and what they may individually need or require. We’ll be able to avoid some side effects as a result of medicines that interact with each other that currently lead to unnecessary additional expenses. In any given condition we give multiple medications whereas in the future we may find out patients only need one or none at all so I think that these will be some of the early, important shifts in the way medicine is practiced.
Q: What research is being done at Scripps in this space and how will that translate to the cures of tomorrow?
A: The most far reaching research is to understand the genomics of the healthy aging. We’re sequencing those individuals in their 80s and 90s who have never been sick. These people would be expected from their genomic profile to have had some diseases like cancer, heart attacks, Alzheimer’s or some other disease of aging. But they don’t get these diseases, so that means they’re protected naturally through what we call “modifier genes.” If we can identify these genes, it would be a great foundation for developing much more impressive preventive strategies for the future–that’s nature’s way of keeping people disease free.
Q: What keeps you up at night?
A: Too many things! But we have a great opportunity to really make sweeping, vital changes in medicine and mainly it’s the excitement at all our projects here, each of which could make a worthy contribution.
Q: What do you do to relax?
A: Hiking, biking, reading, golfing, lots of other activities to relax and not always think about individualized medicine. The years I’ve spent here in San Diego have been the most fun I’ve had in my life!
Q: When you were young, what did you aspire to be as an adult?
A: I didn’t really know I’d be a physician, I thought I’d be an engineer, actually. But when I was in college working in a hospital on a night shift job as a respiratory therapist, working on ventilators in ICUs I’d see these patients who were really sick and after so many shifts, I’d see them turn around. It just really inspired me to pursue a career in medicine--it was just serendipity really.
Q: Any regrets?
A: No! It’s the most extraordinary thing in the world to be entrusted with peoples’ health. There’s no privilege that’s greater than that. I would never give that up. I also enjoy the intellectual stimulation of trying to take medicine to the next level through research while caring for patients. My clinical group of patients has grown so quickly it’s hard to keep up, but really just so rewarding.
Q: What are you reading?
A: Right now I’m reading The Scarecrow, but on the non-fiction side I’m partway into The Innovator’s Prescription. I just got this Kindle so I loaded it up and when I need to escape into a novel, I go to one but when I feel like the other, I can go to that. With the Kindle, it’s a whole new way to read, remarkably effective.
Q: How do you want people to remember you?
A: In 25 years of practicing medicine, I think what I’d want to be remembered most for is doing things that are innovative that will improve overall medicine. Beyond being a good physician, and good husband and father to our two children, I’d want my contribution professionally to be having a positive effect on the future of medicine.
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