It's looking like the end of an era for patient-doctor relationships in the hands-on way that we have grown up with, according to Sidney Lowry, a former Edward VII Memorial Hospital oncologist.Patients are increasingly demanding test results and place much less weight on a doctor's physical examination findings, Dr Lowry believes.He's put his views in a new book, ‘The End of Medicine and the Last Doctor'.“Patients no longer want to be examined. They want an MRI,” he said. “The physician is being gradually replaced by a range of health professionals, and the machine. But the machine has no compassion, no feelings.“Dr Lowry contends that technological advancements are well on the way to displacing the traditional physician.“Because of medical advances, patients now expect miracles,” Dr Lowry told Body & Soul. “People are looking at life extension, immortality. That's not on offer.”Written to appeal to the layperson, Dr Lowry's book reviews medical developments from ancient times to modern day. He looks at the successes, and how they are shaping a change in actual treatments and in the patient-doctor relationship.Dr Lowry also looks at the medical areas currently being developed and how they are impacting or likely to impact society. “The average life expectancy now far exceeds the Biblical threescore years and ten, and most of the massive health budget is spent on trying to add a few extra years to life, without necessarily improving quality,” he said. “Ageing has been redefined as a disease and the financial burden this implies cannot be sustained.”Dr Lowry admitted his book does not look at the financial implications of the Bermuda model of health insurance however, he said, there are many factors driving the cost of health care up around the world.“Some of these costs could be contained, as for instance the unrealistic demands made on some services. It is evident that a degree of rationing will become inevitable, however unpalatable,” he said. Dr Lowry also talks about what he calls “a silent conspiracy in the health care industry”.“There is an unspoken alliance in the health care industry, often well intended, persuading people they need all these tests and pills to stay alive,” he said.“It's creating an undercurrent of health hysteria and its driving up costs inexorably,” he said.Asked if he felt this idea held true for health care in Bermuda where there are genuinely high levels of high blood pressure and type two diabetes, he said: “Obesity, hypertension, and type two diabetes are epidemic in the Western world. Bermuda appears to be one degree worse. This may be partly due to hereditary factors in the relatively small genetic pool on the Island. Certainly we found this earlier in the Bermuda breast cancer study I was involved with a few years ago. “He said the “silent conspiracy” was not referring to diabetes, but to a number of other conditions, including hypertension and prostate cancer.“Hypertension appears to be over-diagnosed. New research indicates that the criteria for blood pressure measurement needs to be more carefully controlled and scrutinised,” he said.“The other so-called ‘conspiracy' refers to the pervasive pressure to take more and more pills. One cynical drug rep allegedly said, ‘There are only two kinds of people: those who need medication, and those who don't know it yet'.”Dr Lowry will launch his new book next Wednesday at a private event for KEMH staff. The book will be available for sale at Bermuda Bookstore, Queen Street.