tag:blogger.com,1999:blog-32053362.post3602425327948209732..comments2024-03-18T06:27:51.599-04:00Comments on Not Running a Hospital: Fool me once, shame on you; fool me twice, shame on mePaul Levyhttp://www.blogger.com/profile/17065446378970179507noreply@blogger.comBlogger8125tag:blogger.com,1999:blog-32053362.post-9515187928242139892013-03-18T17:19:37.287-04:002013-03-18T17:19:37.287-04:00And by what mechanisms do you suggest that we layp...And by what mechanisms do you suggest that we laypeople "verify" competing claims from experts whose financial incentives and associations are sure to be hidden from us, and when it is now apparently the norm for studies funded by commercial enterprises to include non-disclosure agreements and non-publication clauses that become operative when results are open to question or (especially) negative?smartalekhttp://www.testwell.comnoreply@blogger.comtag:blogger.com,1999:blog-32053362.post-42574000674287676882013-03-18T14:12:57.195-04:002013-03-18T14:12:57.195-04:00What needs to be said more: separate the marketing...What needs to be said more: separate the marketing hype from reality when it comes to the selection of surgical techniques. We can no longer just "trust" docs when they say shorter recovery time, etc. We need to "verify" first, then we can trust, or at least hope for the best outcome.Kaimernoreply@blogger.comtag:blogger.com,1999:blog-32053362.post-37391855461968657482013-03-15T08:05:14.001-04:002013-03-15T08:05:14.001-04:00Too bad unnecessary robotic surgery is not part of...Too bad unnecessary robotic surgery is not part of the choosing wisely campaign. Given the track record with Prostate surgery this (hysterectomy by robot) may become the norm as people vote with their feet based on the marketing hype. At our hospital we lost nearly all our prostatectomies to other institutions when we decided not to get a robot because there was no proven clinical advantage. Plus more and more residents are being trained primarily on the robot so if you don't have one it becomes harder to recruit surgeons. Needless to say we now own a robot for surgeries.Jessenoreply@blogger.comtag:blogger.com,1999:blog-32053362.post-32305556337920740452013-03-15T07:43:37.438-04:002013-03-15T07:43:37.438-04:00This is another classic example of why doctors nee...This is another classic example of why doctors need to embrace knowing and caring about costs as an important part of their job. We need robust, user friendly price and quality transparency tools to help them do that with as little incremental demand on their time as possible.Barry Carolnoreply@blogger.comtag:blogger.com,1999:blog-32053362.post-28797729000854248272013-03-15T07:17:36.358-04:002013-03-15T07:17:36.358-04:00From Facebook:
Not only that you've got the l...From Facebook:<br /><br />Not only that you've got the learning curve for the surgeons learning to use the robot. Laparoscopic gyn surgery has been around for a long time.Beverly H Rogersnoreply@blogger.comtag:blogger.com,1999:blog-32053362.post-39357574069180001712013-03-15T07:17:09.688-04:002013-03-15T07:17:09.688-04:00From Facebook:
It is my understanding that roboti...From Facebook:<br /><br />It is my understanding that robotic procedures are always longer than comparable human (non-robotic) procedures. This increases the risk of infection of the open incision and risks associated with anesthesia.Bill Reenstranoreply@blogger.comtag:blogger.com,1999:blog-32053362.post-23617253300044506592013-03-15T07:16:27.863-04:002013-03-15T07:16:27.863-04:00From Facebook:
My extremely awesome urologist/sur...From Facebook:<br /><br />My extremely awesome urologist/surgeon Drew Wagner, who removed my kidney and adrenal gland laparoscopically *with bare hands*, says he does use robots sometimes. They're extremely precise, not shaky, etc, for very fine work. The problem as Paul's wording suggests, is that their marketing *increases* the amount of surgery, instead of just improving the quality of existing surgery. And since all surgery involves risk of harm, such marketing causes harm, IMO.e-Patient Dave deBronkartnoreply@blogger.comtag:blogger.com,1999:blog-32053362.post-34144631834246874352013-03-14T22:48:22.882-04:002013-03-14T22:48:22.882-04:00I remember when you were agonizing over whether/ha...I remember when you were agonizing over whether/having to invest in robotic prostate equipment at the hospital because it was "all the rage" and the men would demand it and go elsewhere if not provided. Wonder if the outcomes are the same.nanahttps://www.blogger.com/profile/16220595303403647789noreply@blogger.com