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Medical Judgment Trumps Medical Innovation

The New York Times says “In Medicine, New Isn’t Always Improved.”

Who can argue with this?

“In Dining, New Restaurants Aren’t Always Better.”

Yes, that’s true, too.  But does it mean anything?

The article is about a type of hip that is apparently going to be the focus of a lawsuit.  The story goes that a lot of people wanted the new hip when it came out, because it was thought to be better than the older ones.  Unfortunately, the hip seems to have hurt some people, some of whom may have been better off getting the older one in the first place.

A doctor quoted in the article suggests it’s part of a uniquely American tic.  We want all of the latest and greatest things for ourselves, it seems.  This story is supposed to be a cautionary tale of what can go wrong when we do.

On the other hand, the latest and greatest things don’t appear out of nowhere.  In America, when people demand something, there will be someone who supplies it.

It’s true.  Doctors, researchers, the government, and, yes, for-profit companies, create things.  They invent diagnostic tests and treatments for disease that never existed before.  One reason why the U.S. has a trillion-dollar health care economy is because there are so many people creating so many new things that people can sanely talk about curing – or at least managing – all disease.  This is a good thing.

But all these breakthroughs are a two-edged sword.

The ability to create increasingly precise treatments means it’s more important than ever to diagnose patients correctly.  Published studies show that misdiagnosis rates are as high as 44 percent.  These studies show these errors happen because doctors are pressed for time, seeing 30 or 40 patients a day.  But whatever the cause, twenty-five percent of patients can’t possibly benefit from the latest medical advances – because they just don’t have the disease for which they are being treated.

Today we have the most medical knowledge, technology and treatments than at any time in history, and yet it’s harder than ever to get people the right care.  Policy-makers must fix an overburdened health care system in serious need of repair.  Let’s get back to basics.  Let’s put a premium on doctors’ judgment, not on how many patients they can see in a day.

*This blog post was originally published at See First Blog*

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