OP-ED

Don’t Stop Medical Innovation

The New York Times says “In Medicine, New Isn’t Always Improved.”

Who can argue with this?

“In Dining, New Restaurants Aren’t Always Better.”

Yes, that’s true, too.  But does it mean anything?

The article is about a type of hip that is apparently going to be the focus of a lawsuit.  The story goes that a lot of people wanted the new hip when it came out, because it was thought to be better than the older ones.  Unfortunately, the hip seems to have hurt some people, some of whom may have been better off getting the older one in the first place.

A doctor quoted in the article suggests it’s part of a uniquely American tic.  We want all of the latest and greatest things for ourselves, it seems.  This story is supposed to be a cautionary tale of what can go wrong when we do.

On the other hand, the latest and greatest things don’t appear out of nowhere.  In America, when people demand something, there will be someone who supplies it.

It’s true.  Doctors, researchers, the government, and, yes, for-profit companies, create things.  They invent diagnostic tests and treatments for disease that never existed before.  One reason why the U.S. has a trillion-dollar health care economy is because there are so many people creating so many new things that people can sanely talk about curing – or at least managing – all disease.  This is a good thing.

But all these breakthroughs are a two-edged sword.

The ability to create increasingly precise treatments means it’s more important than ever to diagnose patients correctly.  Published studies show that misdiagnosis rates are as high as 44 percent.  These studies show these errors happen because doctors are pressed for time, seeing 30 or 40 patients a day.  But whatever the cause, twenty-five percent of patients can’t possibly benefit from the latest medical advances – because they just don’t have the disease for which they are being treated.

Today we have the most medical knowledge, technology and treatments than at any time in history, and yet it’s harder than ever to get people the right care.  Policy-makers must fix an overburdened health care system in serious need of repair.  Let’s get back to basics.  Let’s put a premium on doctors’ judgment, not on how many patients they can see in a day.

Livongo’s Post Ad Banner 728*90

Categories: OP-ED, THCB

Tagged as:

8
Leave a Reply

7 Comment threads
1 Thread replies
0 Followers
 
Most reacted comment
Hottest comment thread
7 Comment authors
pcpdr. storageDan SpinatoPavani Perumallarbaer Recent comment authors
newest oldest most voted
dr. storage
Guest

the misdiagnosis rates are certainly alarming. if doctors paid more attention to their patients instead of just rushing them out the door to get the next one in, people would be a lot better off.

innovation is important, applying it correctly is more important (in my opinion)…

Dr. Mike
Guest
Dr. Mike

rbaer – “Docs elsewhere are known to be more conservative than most (but not all) US docs – mostly to the benefit of their patients.”

Is that why docs elsewhere have a harder time treating basic illnesses like, say, hypertension?

http://hyper.ahajournals.org/content/43/1/10.abstract

pcp
Guest

The article shows that US doctors are better at reaching arbitrary, evidence-free endpoints that do not increase general health or life expectancy. ” Quality measurement” mentality at its worst.

Dan Spinato
Guest

Medical innovation is, I think, one of those occurrences that really never stops. Everyday somebody somewhere discovers something new, it won’t be long til those geniuses figure out the cure for every disease.

Pavani Perumalla
Guest

The modern day lifestyle and stress has increased the incidence of dementia and Alzheimer’s patients all over the world. As more and more elderly get affected by these memory loss related diseases, they become a growing concern for their caretakers. Whether their caretakers are their children or individuals from various NGOs or senior care centers, keeping track of such patients is always a task. Some of the most prominent issues with taking care of patients suffering from Alzheimer’s or dementia are keeping track of their medication and location. Especially, as a slip in either of these could lead to fatal… Read more »

rbaer
Guest
rbaer

I dont know what Evan wants to tell us. “A doctor quoted in the article suggests it’s part of a uniquely American tic. We want all of the latest and greatest things for ourselves, it seems. This story is supposed to be a cautionary tale of what can go wrong when we do.” – I worked/trained in Germany and also spent a couple of mos in France. IMHO that’s flat out true. But I do not see a good connection between the 1st and the 2nd part of the article. Nonsensical medical innovation is about “new” (=patented, expensive) drugs, new… Read more »

MG
Guest
MG

So is there a clawback or some time of penalty when a physician doesn’t diagnose the problem correctly if we are going to place more economic emphasis on the diagnosis portion of the patient visit?

I would be much more interested to see if there is any literature out there that looks at patient visit times & effects on actual outcomes besides patient satisfaction rates.

Dr. Mike
Guest
Dr. Mike

It’s ironic that everything the policy wonks dream up to “reward” my cognition or judgment ends up doing exactly what you are arguing against – it necessitates me seeing more patients to pay for the cost of proving that I measure up. In the context of any discussion about rewarding physicians for their “judgement” or “cognition”, we of course must equate “measure” with “reward” because everyone knows those devious doctors will cheat if we don’t hold them accountable. Let’s make a medical home and add another FTE in the form of a case manager. Let’s mandate EHRs and add at… Read more »