Monday, May 17, 2010

Medinnovation Post , "Americans and Their Medical Machines, "Appears on The Health Care Blog

I am pleased to report that my recent post, “Americans and Their Medical Machines, “ has been reprinted in the May 17 edition of America’s most widely read blog – The Health Care Blog. That blog is the brainchild of Matthew Holt, a British-born San Francisco based policy geek. Matthew, with his partners, created the Health 2.0 movement. It empowers health consumers to seize control of their health care and to work in concert with their physician partners.

Here are three comments on my blog, along with my response to their comments.


Food for thought. Thank you for the perspective and well written blog. We appreciate anything & everything that keeps the inner machine (brain) operating smoothly.

Posted by: s. williamson | May 17, 2010 8:49:28 AM

So I guess ECMO, dialysis, Bypass pumps, Defibrillators should all have been nonstarters? By extention, there was no need to invent the refrigerator since folks were getting by with ice-boxes. Bring on the Luddites.

Posted by: Doc99 | May 17, 2010 11:37:42 AM

What a wonderful post. If this idea can be combined by an individual visiting i hope things will totally work together for good.

My Response to Comments

I am all for innovation. I have written a book promoting it Innovation-Driven Health Care, (Jones and Bartlett, 2007), and I have spent the last three years blogging at Medinnovationblog, which now has 1321 entries.

In this particular blog, I was simply trying to say we ought to put medical machines in perspective. They work, they save lives, we love them, they cost a lot of money, and they have created a vast industry.

I meet most mornings for coffee with a group of 65 year + males, and all of us have experienced an invasive medical procedure - cataract surgery, coronary stents, abdominal aneurysm stents, hip and knee replacements, rods in the vertebral column - and I'm happy to report because of these wonderful procedures, we're all productive and functioning.

On the payment side, however, collectively these procedures, more widely available and more quickly accessible than in any other country, are driving Medicare over the financial cliff.

Obamacare promises to cut $535 billion out of Medicare. Can this be done without rationing these procedure in some way and without running into stiff political resistance from those of us who have come to expect the benefit of these technological innovations.

I am no Luddite. Instead I am a medical machine advocate. My fondest hope is that we about to enter the age of Disruptive Innovation and Disruptive Decentralization, already signaled by Health 2.0 and portable devices that can be deployed in physicians offices and patients homes, to be put into action at lower costs in more convenient settings. In a more recent medinnovation blog I give practical examples of these disruptive devices that are already at work.

Dr. Reece, I would love for you to elaborate on that. There are multiple things that come to mind:

1) Americans seem to be particularly prone to machinistic and overly simplified explanations of complex physiologic processes (both physicians offering them ad patients expecting them).

2) The US has a culture of medical technology enthusiasm that is probably unmatched worldwide, leading to true innovation as well as nonsensical pseudo-progress.

3) From what I read, it is the UK that has developed the counterculture of technology skepticism and a stingy, conservative approach to medical technology. France and Germany are, as a whole, probably in--between.

4) If the body is a machine, then any problem has to be explainable in mechanistic terms. Medically unexplained symptoms are extremely common, and yet few Americans are willing to entertain the thought that their symptoms may be related to anxious over observation and psychiatric disease. And the latter, of course, is a chemical imbalance of brain transmitters.


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