OT [Industrialized medicine] could never happen here
Why not?
Complications amazon.com
looks like a great read. I'm continually amazed by the fruit that the Indian diaspora has brought to our shores. My 86 year old mother, who lives with us, is scheduled to have surgery next week for the first time in her life (rectal prolapse). Normally, I wouldn't put her through the trauma of an operation at her age, but it has the potential to make a real difference in the quality of her life.
The idea of going to a particular specialized "hospital" for a particular operation, like the one Gawande describes in Scandinavia dedicated to hernia repair, is fascinating. It is not surprising to me that this is the most "efficient" place in the world for this operation. What would prevent the proliferation of such specialized surgery centers in Boston, New York, Chicago, or Los Angeles? I would not hesitate to go to a colorectal surgery center staffed by trained and certified chimps if it were shown they had a better success rate than Harvard MDs.
I can understand how the US medical culture is resistant to attempts to "industrialize" medicine, but I think that the insurance companies are leading the charge and the docs will have to dance to the piper's tune. I can foresee a gradual transformation taking place toward this Scandanavian model, first with traditionally trained docs, and then gradually with "paradoctors". If more and more legal tasks have been outsourced to paralegals for obvious reasons, why would you be so conservative in your assessment for the potential for "parasurgeons" in the most innovative nation in the world? What professional culture is more conservative than the culture of law?
If your point is that we need to analyze the barriers to change in order to better control runaway medical costs, I completely concur. The "system" is certainly inherently conservative. However, as the key economic driver of change in medicine is already the insurance company, I view the evolution toward industrialized medicine in the USA as an ineluctable transformation.
Sam |
