Our chiefs of service at BIDMC are technically and academically tops. Plus, they are great people. Plus, they have good senses of humor. Every now and then a one-liner pops out that is especially worth memorializing.
Today at Medical Executive Committee, we were voting on approval of procedures and therapies. The topic was adult intraosseus device use. This is a gizmo that screws into a bone that permits the delivery of medication into the marrow. It is for those cases in which access to blood vessels is not possible. I am told that this doesn't happen often, but that it is good to have the devices in reserve for emergency department and ICU situations.
Well, the group got to talking about what these devices look like now and how they compare in functionality and cost to ones used in prior years. Finally, our Chief of Anesthesiology summarized the discussion by saying, "So now we have a new expensive device that is just as good as the old cheap one."
In health care, plus ça change, plus c'est la meme chose.
Speaking of which, I am told of an article in the New England Journal of Medicine by Barbash and Glied, entitled "New technology and health care costs - the case of robot-assisted surgery." Aug. 19, 2010 pp 701-704. A friend sent an excerpt:
"... [R]obotic technology may have contributed to the substitution of surgical for nonsurgical treatments ... increased both the cost per procedure and the volume of cases treated surgically.... The evidence suggests that despite the short term benefits, robotic technology may not have improved patient outcomes or quality of life in the long run."