“Creative destruction”, a sometimes throwaway phrase with deep implications, occurs when creativity in all its forms (novelty, invention, or imagination) lays waste to established forms of culture, belief, politics, business (manufacturing and distribution,) even behavior. The results can be as profound as revolutionizing, annihilating or causing replacement of whatever existed before. Examples abound throughout history. Consider: the railroad and the automobile vs. horse and carriage, radio vs. the telegraph, email vs. the post office, social networks and the Internet vs. the publishing industry, the smart phone vs. the recording business, photography, even TV. At times, the obverse, “destructive creation” can be inferred as a kind of feedback loop. The crossover point is somewhere between progress and failure.
Examples of destructive creation come to mind, such as software upgrades killing off perfectly good software to force consumers and industry alike into upgrading. Consider the cost we endure for the replacement rate resulting from new products.. By discarding our household goods, cars, old TV’s, computers, and mobile phones, we “destructively” increase toxic and other waste. “Progress” thus results inevitably in environmental degradation.
Destructive Creation and Medicine
Medical Progress in the form of immunization, antibiotics, cardiac surgery, revolutionary imaging, etc. has been a colossal success story over the past century, conferring on our age extravagant improvement in health and longevity. Yet from time to time, we suffer disillusion when we learn, often long after the fact, that some promising new drugs are so dangerous they’ve been taken off the market, that uncountable cardiac procedures, such as catheterization, stent placement, implantable pacemakers were not indicated, that tens of thousands of joint replacement need never have been performed.
Dr. Eric Topol, in his 2011 book, “The Creative Destruction of Medicine: How the Digital Revolution Will Create Better Health Care”, rhapsodizes over our smart phone detecting cancer cells, monitoring your brain waves, or warning you of an imminent heart attack. Could this be overshooting the runway? At the same time Topol was on the money when he predicted our vital signs could be monitored continuously, perhaps even our blood chemistries. After all, we now have the soaring stock price of the new IPO, Fitbit, “which tracks every part of your day—including activity, exercise, food, weight and sleep—to help you find your fit, stay motivated, and see how small steps make a big impact.
Does this mean we can now commodify the medical profession, as well as healthcare itself, by simply replacing them with digital technology and mobile devices?
Martin F. Sturman, MD, FACP
copyright 2015, Mathemedics, Inc.