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Robert Wachter - The Digital Doctor: Hope, Hype, and Harm at the Dawn of Medicines Computer Age

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The New York Times Science Bestseller from Robert Wachter, Modern Healthcares #1 Most Influential Physician-Executive in the US

While modern medicine produces miracles, it also delivers care that is too often unsafe, unreliable, unsatisfying, and impossibly expensive. For the past few decades, technology has been touted as the cure for all of healthcares ills.

But medicine stubbornly resisted computerization until now. Over the past five years, thanks largely to billions of dollars in federal incentives, healthcare has finally gone digital.

Yet once clinicians started using computers to actually deliver care, it dawned on them that something was deeply wrong. Why were doctors no longer making eye contact with their patients? How could one of Americas leading hospitals give a teenager a 39-fold overdose of a common antibiotic, despite a state-of-the-art computerized prescribing system? How could a recruiting ad for physicians tout the absence of an electronic medical record as a major selling point?

Logically enough, weve pinned the problems on clunky software, flawed implementations, absurd regulations, and bad karma. It was all of those things, but it was also something far more complicated. And far more interesting . . .

Written with a rare combination of compelling stories and hard-hitting analysis by one of the nations most thoughtful physicians, The Digital Doctor examines healthcare at the dawn of its computer age. It tackles the hard questions, from how technology is changing care at the bedside to whether government intervention has been useful or destructive. And it does so with clarity, insight, humor, and compassion. Ultimately, it is a hopeful story.

We need to recognize that computers in healthcare dont simply replace my doctors scrawl with Helvetica 12, writes the author Dr. Robert Wachter. Instead, they transform the work, the people who do it, and their relationships with each other and with patients. . . . Sure, we should have thought of this sooner. But its not too late to get it right.

This riveting book offers the prescription for getting it right, making it essential reading for everyone patient and provider alike who cares about our healthcare system.

Robert Wachter: author's other books


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Advance Praise for The Digital Doctor

The Digital Doctor is the eye-opening, well-told, and frustrating story of how computerization is pulling medicine apart with only a vague promise of putting it back together again. I kept thinking, Exactly! while reading it, and that is a measure of Wachters accomplishment in telling the tale. This is the real story of what its like to practice medicine in the midst of a painful, historic, and often dangerous transition.

Atul Gawande
author of Being Mortal and The Checklist Manifesto

As scientific breakthroughs and information technology transform the practice of medicine, Bob Wachter is one of the few people with the insight, credibility, and investigative skills to go from the trenches to the observation booth. The Digital Doctor is first of all a personal journey, as Wachter travels the country, meets with key players who are shaping our future, and wrestles with their views. His intimate narrative left me entertained, amazed, alarmed at times, but always engrossed as I came to a new understanding of my own profession as it is being reshaped by technology. Simply brilliant.

Abraham Verghese, MD, MACP, FRCP (Edin)
Professor and Vice Chair for the
Theory and Practice of Medicine,
Stanford University School of Medicine;
author of Cutting for Stone

A much-needed study of the moment in technological change we dont want to see: the in-between moment where technology is making things worse because we just assumed that adding it would make things better. Wachter maintains his enthusiasm for the long view, but helps the reader see that getting there requires an understanding of medicine and technology and, most of all, of people and their needs. It requires thinking and caring; the hope for a magic bullet got in our way. Wachter deserves our gratitude for his clarity of vision and our support so that his views can become influential in policy circles.

Sherry Turkle
Professor of the Social Studies of Science
and Technology, MIT; author of Alone Together:
Why We Expect More from Technology
and Less from Each Other

Ive long admired Bob Wachter for his skill and acumen as a physician and as a leader in the field of patient safety and healthcare quality, but this book has made me appreciate him in a new light. In The Digital Doctor, Wachter is our indispensable guide through the computerization of medicinethe rich history, the forces that impede progress, and the potential for todays technology innovations to transform every aspect of healthcare. Read this book and you will see the future of medicine.

Marc Benioff, Chairman and CEO, Salesforce

Noted physician-author Bob Wachter takes the reader on a fascinating journey of discovery through medicines nascent digital world. He shows us that its not just the technology but how we manage it that will determine whether the computerization of medicine will be for good or for ill. And he reminds us that the promise of technology in healthcare will be realized only if it augments, but does not replace, the human touch.

Captain Chesley Sully Sullenberger
speaker; consultant; author of Highest Duty and
Making a Difference; pilot of US Airways 1549,
the Miracle on the Hudson

With vivid stories and sharp analysis, Wachter exposes the good, the bad, and the ugly of electronic health records and all things electronic in the complex settings of hospitals, physician offices, and pharmacies. Everyone will learn from Wachters intelligent assessment and become a believer that, despite todays glitches and frustrations, the future computer age will make medicine much better for us all.

Ezekiel J. Emanuel, MD, PhD
Vice Provost for Global Initiatives and Chair, Departments of Medical Ethics and Health Policy, University of Pennsylvania

In Bob Wachter, I recognize a fellow mindful optimist: someone who understands the immense power of digital technologies, yet also realizes just how hard it is to incorporate them into complicated, high-stakes environments full of people who dont like being told what to do by a computer. Read this important book to see what changes are ahead in healthcare, and why theyre so necessary.

Andrew McAfee
cofounder of the MIT Initiative on the Digital Economy; coauthor of The Second Machine Age

One of the best books Ive ever read. Wachters warm humor and deep insights kept me turning the pages without interruption. To make our healthcare system work, we need new models of care and new ways of managing our technology. The Digital Doctor brings us much closer to making this happen, which is why I finished the book far more optimistic than I was when I began it. It is a must read for everyonepatients, clinicians, technology designers, and policy makers.

Maureen Bisognano
President and CEO, Institute for Healthcare Improvement (IHI)

An engaging, accessible, and terribly important book by one of our finest medical writers. The electronic health record not only is the most disruptive innovation in the history of healthcare, but will also prove to be transformative. In his inimitable mix of conversation, reporting, and insightful analysis, Bob Wachter explains to you why. A must read for healthcare professionals and the public alike.

Lucian Leape, MD
Professor, Harvard School of Public Health and Chair, Lucian Leape Institute of the National Patient Safety Foundation

The Digital Doctor truly defines todays epoch of technological transformation in healthcare. Wachter tells a gripping tale about the personalities and politics behind healthcares digital revolution. With a sweeping view that takes us from the grand political battles in Washington to the subtle changes in the interactions between people when a computer enters the picture, Wachter offers surprising, often shocking insights into how technology changes the daily lives of clinicians and patientssometimes for the better, sometimes for the worse.

Leah Binder, MA, MGA
President and CEO, The Leapfrog Group

In this brilliant and compelling book, Wachter provides us with a view from the balcony of the last decade of healthcare information technology. As one of the players, Im amazed by the way hes captured the characters, the plot subtleties, and the triumphs and tragedies of the work weve done. This book is the definitive chronicle of our modern efforts to wire our healthcare system.

John Halamka, MD
Chief Information Officer, Beth Israel Deaconess
Medical Center; Professor of Emergency Medicine, Harvard Medical School

Wachter not only has unmatched insider knowledge of healthcare but deeply understands technology as well. This breadth allows him to prescribe commonsense solutions to the problems emerging from the inevitable marriage between the fields, which he reveals as a more troubled union than many suspect. The Digital Doctor not only enlightens and awakens, but is a delight to readrare for such an important book.

Steven Levy
author of Hackers and In the Plex

A fascinating and insightful look at the digital transformation of healthcare, thoroughly researched and brought to life by dozens of stories and interviews with practicing clinicians. Wachter plots a realistic road map for navigating the obstacles ahead, without the hype that frequently accompanies digital health solutions. Its an essential read for anyone involved in our healthcare system, from everyday providers in exam rooms to politicians and policy makers who shape the system.

Kevin Pho, MD

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