Sunday, May 9, 2010

Dr. Reece’s Pieces – May 9 Medinnovation Blog – Americans and Their Medical Machines

The real problem is not whether machines think, but whether men do

B. F. Skinner (1904-1996), Contingencies of Reinforcement(1969)

If you are designing a machine, you had better think of everything, because a machine cannot think for itself.

B. Zimmerman, C. Lindberg, P. Pisek, Edgeware: Insights from Complexity Science for Health Care Leaders, 1998

Obsession with medical technologies and machines characterizes American’s cultural expectations. We tend to think of our bodies as perpetual motion machines, to be preserved in perpetuity. If the face of our machines sag, we lift its faces up. If our pipes clog, we roto rooter them out or stent them. If impurities gum up our machinery, we filter them out. If our joints give out or lock up, we replace them. If we want to remove something in the machine’s interior, we take it out through a laparoscope. If the fuel or metabolic mix is wrong, we alter the mix or correct the metabolic defect with drugs If anything else goes wrong, we diagnose it and rearrange it electronically.

We are reluctant to let nature take its course. We rely on half-way technologies and machines to do the job of keeping us looking young, active, functioning , and alive. This fixation on machines and technologies is the big reason American health care is 50% more costly than that of other nations. With rapid access to machines and our reliance on them, we deliver a different product than other countries – more technologies and more machines, faster and more often. Our belief system is : Give a specialist a machine, and he or she will do the job, and we or the government will pay for it.

We love machines - heart lung bypass machines, dialysis machines, heart rhythm machines, imaging machines, Internet-run machines, ventilation support machines to keep us alive at the end of life. . Patients and lawyers expect us to use these machines, doctors constantly innovate to produce more machines, and we tend to use them – no matter what the cost.

Go to a cardiology convention, and you will witness display after display of heart rhythm pacemakers. Go to an orthopedic convention, and you will think you are in an industrial exhibit, with new devices as far as the eye can see and the mind can comprehend. Go to an orthopedic operating room, and you will hear the sounds of hammers and chisels and rods being inserted. Go to a hospital convention, and much of the chatter will be about new technologies and machines that attract more patients and more specialists, reverse the ravages of disease, and to enrich the bottom line.

The latest and most talked about machine in hospital marketing and in the hands of surgical specialists such as urologists, heart surgeons, and gynecologists is the da Vinci surgical robot, a $1.4 million machine named after Leonardo da Vinci. It is designed to be less invasive, to cut blood loss, to minimize complications, to increase hospital market share and revenues, and to attract both patients and specialists to hospitals.

The price is high, $1 million to $2.25 million per machine depending on the model, $140,000 a year for maintenance, and $1500 to $2000 per procedure for replacement parts. The manufacturer of da Vinci, Intuitive Surgical, Inc, must be doing something right. Last year it had a profit of $233 million on sales of $1.05 billion. It is deployed in 853 hospitals, large and small.

But, as with all medical machines, da Vinci is not infallible . It relies on the expertise and experience of its physician users (See Wall Street Journal, May 5, “Surgical Robot Examined in Injuries.”)
The human body is not a machine, and not all of its problems and eccentricities , given the individualities and variabilities of the human condition, lend themselves to automatic or flawless operation and correction. Complications happen. Human judgment is still required.


Unknown said...

Thanks for the great and useful post/article.
Medical Laboratory equipments

Anonymous said...

Willkommen und Hallo hier im Sex-Talk.

Der Sex-Talk gibt ihnen eine Alternative heiratsvermittlung und vieles mehr,sicherlich auch sexuellen Vorlieben ausleben
Hier im besten Sex-Talk erwarten dich heiratsvermittlung Live Dates
Suchst du Blind Date , dann bist du hier genau richtig.Ok los geht es,stellt sich die Frage,worauf wartest du?
Live Dates nackte frau sexy ,anmelden .
Suchst du jemand in Genf, oder deutschland, oder Trier , oder aus Langenthal, in Villars-sur-Glâne? Mit Sicherheit kein Problem.!

Anonymous said...

Hallo in unseren Sex-Talk.

Dieser Sex-Talk gibt dir die Alternative singl und vieles mehr,wie sexuellen Vorlieben ausleben
Hier im Sex-Talk erwarten dich singl Aufregend chatten
Eventuel suchst du Sexgeschichten , mit Sicherheit bist du hier genau richtig.Ok,worauf wartest du?
Heiße Live Chats kontakte partnersuche ,anmelden .
Du suchst jemand von Zürich, vieleicht aus Magdeburg, oder von Düsseldorf , vieleicht aus Basel-Landschaft, oder in Hard? Sicher kein Problem.!

Anonymous said...

Hallo in unseren Flirt-Chat.

Der Flirt-Chat bietet ihnen die Alternative ficken sofort und vieles mehr,sicherlich auch sexuellen Vorlieben ausleben
Hier im besten Flirt-Chat erwarten dich ficken sofort sexuellen Vorlieben
Suchst du Flirt und Sextalk , dann bist du hier genau richtig.Ok,los gehts,auf was wartest du?
Heiße Live Chats privat sex ,anmelden .
Suchst du jemand aus Meyrin, in Leverkusen, in Basel-Landschaft , vieleicht von Aargau, oder von Arth? Bestimmt ist da jemand dabei.!

Anonymous said...

Willkommen in unseren Sexchat.

Der Sexchat gibt dir eine Möglichkeit geile votzen gratis und vieles mehr,sicherlich auch Flirt und Sextalk
Hier im besten Sexchat findest du geile votzen gratis Flirt und Sextalk
Suchst du eventuel Aufregend chatten , mit Sicherheit bist du hier genau richtig.Gut,stellt sich die Frage,worauf wartest du?
erotische Rollenspiele private frauen nackt ,sofort anmelden .
Suchst du jemand aus Genf, vieleicht in Karlsruhe, vieleicht in Muttenz , oder Zürich, oder von Mödling? Sicher kein Problem.!

Anonymous said...

Hallo hier im Sex-Chat.

Der Sex-Chat bietet dir die Alternative versaute frauen und natürlich vieles mehr,wie Heiße Live Chats
Hier im besten Sex-Chat findest du versaute frauen sexuellen Vorlieben
Suchst du Sexgeschichten , dann bist du hier genau richtig.Gut,stellt sich die Frage,worauf wartest du?
erotische Rollenspiele frauen flirten ,anmelden .
Suchst du jemand aus Dornbirn, in Halle, vieleicht aus Recklinghausen , vieleicht von Genf, oder von Oberwil? Mit Sicherheit kein Problem.!

Anonymous said...

Heу wοuld you mind lеtting mе κnow ωhich hοѕting соmpаny уou're using? I've loаԁeԁ
yοuг blog in 3 сοmpletelу diffеrent
internеt brоωseгѕ and I must say this blog loads
a lot faster then most. Can you rеcommend a good internet hoѕtіng
provіdeг at a reasonable prісe?
Kuԁοѕ, I apprеcіatе it!
My homepage ; watson Aberant llp chartered accountants

Anonymous said...

I think this is οne of thе mοst significant іnformation for me.
Anԁ і'm glad reading your article. But wanna remark on few general things, The web site style is great, the articles is really excellent : D. Good job, cheers
Review my blog post -