Cyborg Surgery

The medical industry is one of excitement and constant evolution.  Almost daily we see the emergence of new products, devices, medications and practices that improve, and save, the lives of people around the world.  It is no surprise then, in this age of technology, that there has been a substantial rise in the production and use of robotic surgery devices.  One such device is the da Vince, which allows doctors to perform certain minimally invasive surgeries that would otherwise be impossible.  However, recent controversy has arisen over the safety of the device after reports surfaced of injuries related to its use.  According to an article in the Wall Street Journal entitled “Surgical Robot Examined in Injuries,” there is no evidence that shows the injuries were related to machine malfunction but rather to error on the part of the surgeon.  Doctors who use the device agree that it does take a significant amount of experience to master; some say as many as 700 surgeries.  The device has seen success in larger hospitals where the volume of patients is much higher and the doctors have an opportunity to gain experience faster.  Smaller medical centers, however, are being pressured into buying the machines to remain competitive as patients are now favoring the hospitals that use them.  However, none of the injuries in surgeries where the da Vince was used can be proven as caused by the machine and experts say that doctor error and inadequate training is to blame.  Some doctors are reluctant to embrace the machine but it appears that it is fast becoming a standard tool of the trade.  It seems that the power of the da Vince, like any other tool, lies not in the machine, but in the hands of its operator.

Ask Your Doctor

A recent article in the Huffington Post entitled “Healthcare Reform Needs Media Reform” by Rory O’Conner examines the issue of healthcare advertising. While there will be a hearty portion of “change” in the House-passed Healthcare Bill, there will not be any regarding the laws allowing direct-to-consumer (DTC) advertisement of drugs.  Currently the U.S. is one of only two countries who allow such messages; the ones that encourage consumers to “ask your doctor” about a specific drug.  According to the American Advertising Federation or AAF, opponents of OTC advertising say that it “raises the price of prescription drugs or promotes unsafe dispensing.” O’Conner’s article further states that OTC advertising causes patients to ask for “unnecessary prescriptions and to expect a prescription for every condition.” However, those in favor say that these types of ads prompt viewers to see their doctors about illnesses when they would not have otherwise done so.  According to AAF,  “these ads prompted more than 39 million to ask their doctor about a particular health condition.”  These types of ads also generate huge revenue for both the media outlets that carry them as well as the prescription drug industry, generating up to four dollars in revenue for every dollar spent on advertising.  O’Conner and other opponents argue that overspending on prescription drugs is a large factor in the increasing healthcare costs and therefore should be reformed in the Healthcare Bill. 

Others claim that a patient armed with information provided by these DTC ads actually help contain overall costs because patients are addressing specific disease or physical conditions that threaten their health.  Physicians do not prescribe drugs that patients do not need, but an informed patient is taking charge and being responsible for their health by partnering with their provider in these discussions. An ounce of prevention is worth a pound of cure!

 

My Two Cents

In regards to a recent New York Times article on plastic surgery…With the economy in a slump, many people are cutting back significantly on “discretionary spending;” from luxury automobiles to fine dining, many industries have taken a severe hit.  The medical industry is no exception to this trend, with unnecessary procedures seeing a steady decline.  Plastic surgery has taken one of the biggest hits along with declines in other procedures not usually covered by insurance such as Lasik eye surgery.  While we can blame the economy for the decline in these types of discretionary procedures, it was the high popularity of such procedures that, in fact, contributed to the economic decline in the first place.  “At the height of the plastic surgery boom several years ago, many people simply charged their breast implant surgeries to their credit cards, or applied for special lines of credit to cover such procedures, or took out second mortgages on their homes.”  It seems that even in a stronger economy, many people still didn’t have the money to afford these procedures.  Perhaps the recession will help Americans redefine what we see as truly important.

Healthcare Informatics Savings

For the last several presidential election cycles, we have witnessed candidates quote on numerous occasions, unrealistic goals and cost savings associated with the modernization of electronic healthcare records management. Why does this task never seem to get done? Is this really a smoke and mirrors story that will save money, but not deliver on the promise of true healthcare reform? Healthcare informatics’ best contribution will be in the area of patient safety. The fifth leading cause of death in America is medical errors. Yes, errors in the treatment rooms of America and the leading cause of medical errors is medication errors. Place the needed tools in the need space-patient safety.

Solving the healthcare crisis in America

The rising cost of healthcare can easily be seen in the treatment of chronic diseases. 70% of all healthcare costs are used to treat the top five chronic diseases. Control chronic disease and you control healthcare costs. For example, if we reduced the body mass index (BMI) of the average over weight American by 20% we would have a significantly impact on the diabetes, heart disease, stroke and other costly diseases. Individual responsibility is the key to reaching these goals. Politicians popularize the notion that billions can be saved in improving healthcare informatics and Medicare fraud waste and abuse reduction. The real savings is in the control and prevention of chronic diseases. As a nation it would make better sense to prescribe Satin drugs to Americans that need it at no charge and to provide healthcare memberships for free.