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Unnecessary Medical Procedures and the Dangers of Robot Surgery
Hugh Pickens writes "The LA Times reports that in a new report aimed at improving healthcare and controlling runaway costs, a coalition of leading medical societies has identified nearly 100 medical procedures, tests and therapies that are overused and often unnecessary. The medical interventions — including early cesarean deliveries, CT scans for head injuries in children and annual Pap tests for middle-aged women — may be necessary in some cases, but are often not beneficial and may even cause harm. 'We are very concerned about the rapidly escalating cost of healthcare,' says Dr. Bruce Sigsbee. 'This is not healthy for the country, and something has to be done.' Each of the specialty medical societies has provided a list of five procedures that physicians and patients should question about the overuse of medical tests and procedures that provide little benefit and in some cases harm. A 2012 report from the independent Institute of Medicine estimated total waste in the system at 30%, or $750 billion a year. 'Millions of Americans are increasingly realizing that when it comes to healthcare, more is not necessarily better,' says Dr. Christine K. Cassel." According to pigrabbitbear, it's the robots we should be wary of. He writes "'We are committed to helping victims of robot surgery receive the medical care and compensation they deserve. As both a lawyer and a licensed medical doctor, Dr. Francois Blaudeau has made it his mission to fight for the victims of traumatic complications as a result of botched robot surgery.' That's the opening salvo from the medical malpractice lawyers who run the slick fear factory of a website, BadRobotSurgery.com. According to the doctor-lawyers behind it—doctor-lawyers like Francois Blaudeau, MD, JD, FACHE, FCLM—'thousands of people have suffered severe and critical complications at the hands of surgical robots. In fact, 'robotic surgery has been linked to many serious injuries and severe complications, including death.'
Why are these two unrelated topics in a single post? The word 'robot' does not even occur in any of the 'Unnecessary Medical Procedures' articles (does using 'find' count as RTFA'ing?)
Human surgery has been linked to many serious injuries and severe complications, including death.
And I think many more such cases overall than for robot surgery. Horror stories can be found always, just a matter of searching hard enough.
The question is: which one is more reliable overall?
With this "robot surgery" is it 2060 or just April first?
Remote control surgery via endoscope, lapriscope or whatever has a human being driving a tool. There are no droids to be looking for.
The robots in robot surgery are not the same as the robots in Isaac Asimov. A DaVinci robot has no autonomy at all, but is really just telepresence, an extension of the surgeon's hands and eyes. If anything goes wrong, it is the surgeon who is ultimately at fault (baring any mechanical or electrical problems, which I don't think they are alleging).
The BadRobotSurgery.com lawyers must know this; their web site sounds like it has all of he subtlety and morality of a Karl Rove political ad campaign.
And, of course, none of this really seems to have anything to do with unnecessary ,medical procedures.
No doctor wants to be on the stand in a courtroom and get asked:
"So, if you'd just done this one easy surgery, the dear deceased might be with us today?"
Inevitably, it ends up looking like the doctor wanted to "save money" by avoiding a $100 test or $500 surgery and that's what killed poor dearly departed.
Also, an order has suppressed evidence that the dearly departed was 500 lbs and smoked 4 packs a day while eating nothing but cheesburgers with bacon.
That kills the cost curve. So does the paperwork, which has hospitals hiring more paper-pushers than doctors and nurses. All of this stuff is backward looking, designed to avoid that one moment in trial where it sounds to 12 half-awake people that maybe the rich evil doctor just didn't care enough.
Futurist Traditionalism
I don't need to see the list to know it's not there. Where is routine infant male genital mutilation? You want to save a quick $300 bucks? And possibly thousands more as I've had to spend OUT OF MY OWN POCKET to deal with complications?
For fuck's sake.
The same robots that can assemble iphones will be able to do open heart surgery.. except many, many times faster. The same cameras that provide high speed film will be able to drive high speed image recognition of what needs fixing, in multiple spectrums, in real-time.
http://www.youtube.com/watch?v=-KxjVlaLBmk
That is one lab in Japan, and it's several years old. The state of the art in this technology is nothing short of breathtaking. It's being driven by cheap processing time. 50 years of computer science (real computer science) on vision systems is now all coming to life.
What's the problem? Well.. it will render advanced surgeries a commodity. Doctors have egos worse than fighter pilots, and you just wait until drones and computer piloted autonomous planes start shooting down the real deal. It's over then. Doctors are not stupid people, and the smarter ones are realizing this now.
Robotic surgeries will dramatically improve life for millions of people, and while there is a development curve, they will ultimately be superior in every way, as sure as hand-milling was replaced by CNC equipment.
Exciting times we live in.
..don't panic
Same thing goes for surgeons, but a robot has two qualities that your run of the mill surgeon doesn't: It is consistent in its results (you can end up in the hands of a drunken surgeon, someone who just lost a familiar, or it just happens to have a bad day), and it is cheaper (in the long run).
Robotic surgery doesn't mean what you seem to think it means. It isn't an autonomous robot doing the procedure. It is a doctor doing the procedure using robotic technology to enhance and assist. It improves capabilities for minimally invasive surgery and remote surgery but it is not what you are describing.
Automation is coming to all other aspects of life, shedding jobs at its wake. I don't see why doctors need to be protected from that, as long as automation brings some benefits to society.
Common misconception. Automation does not "shed jobs", it simply pushes the jobs elsewhere. We automated farming and that freed the labor force to work in manufacturing and services and we all have benefited greatly from that shift. Manufacturing is now being increasingly automated for many things freeing labor for more valuable tasks. A lot of work is not value added. A lot of my work is as an accountant. Theoretically I could keep the books by hand like they did before computers with large staff but that adds no economic value to what we do, just cost. Better to use Quickbooks and automate and apply that labor more productively elsewhere. The purpose of jobs is not to provide a paycheck. The purpose of jobs is to do economically useful work. If a machine can do the work more economically that labor needs to be applied elsewhere.
Doctors don't need to be protected from automation any more than anyone else. If anything they welcome the productivity improvements automation can provide, particularly on the administrative side of things. But it's pretty hard to automate a checkup or removing an appendix. We give them a lot of training because those skills are not presently replaceable with any technology we possess. Perhaps that will change someday but it won't be anytime soon.
Why is an injury lawyer’s marketing campaign posted at all on Slashdot, let alone next to an unrelated LA time article? The article quoted in the second part of the post actually says exactly the opposite of what the post states. Does anybody on slashdot know what 'editor' means? What grades did the slashdot editors get on reading and comprehension on elementary school?
In it, they report uninsured patients get charged 11x what would be allowed if the patient qualified for Medicare. It used to be health insurance companies would be able to get rates 20% to 30% over the Medicare rate. Now, because of hospital consolidation, the insurance companies are being forced to pay 5x the Medicare rate. The author wasn't able to find any actual financial reason for the markup. (Things like, $1.50 for an acetaminophen pill, when a bottle of 100 costs $1.50. Or a blood glucose test strip costing $18, when supermarkets sell them for $0.60.)
Here's the article.
I'm not even remotely surprised that 30% of medical advice / treatment is waste. I have to see a lot of doctors for a very weird condition I have and the amount of time they either recommend a MRI ( I've had like 7 ) or EEG ( I've had like 5 ) or another costly and redundant medical test is amazing. I even have cases where one doctor will order a MRI, EEG and SLEEP STUDY only to refer me to a doctor who will run the EXACT same tests.
/10 issue in your life lets drop it". He's right, if you can live with what you have and you don't need medical treatment then just don't get it. The human body is able to treat itself fairly well, doctors should only be called in when you body can't help, instead of the current model where you sneeze and all of a sudden need a MRI, Vaccination, Med leave from work, Clean room and Cancer tests.
Now even if I don't focus on the random testing they do which is massively overkill, they like to give me medicine like it's going out of style. I so far over the last 5 years have been switched on and off maybe 20 high power level nerve medications, all of which run a steep price tag and have a HUGE health risk attached. In some cases they will give me some super power new nerve med which will give me a new issue which they will order tests and new meds to treat!!!
I think my GP says it best 3/4 of the time, "Fuck off and shut up, If it's not causing at least a 7
My problem is the opposite: it's not about the unnecessary stuff, it's about the cheap, non-invasive things they could do that they stay away from like if it was a transplant or something. My pregnant wife had to spend a couple of hours bleeding in the ER for a clueless resident to finally pick up the ultrasound and tell us "well, there's an apparently intact fetus with a beating heart, stuff happens, no need for a cleanup surgery, go home". They were already setting up an OR for a D&C -- what kind of an idiot does that before doing a basic ultrasound that takes 60 second start-to-finish?!
Another story: I have a solid family history (with tombstones and documented post-mortems to prove it) of plaque formation in coronary arteries, and the doofuses would drag their feet on noninvasive transthoracic ultrasounds of precisely the non-invasevely accessible parts of those arteries that were problematic in my family! I mean, come on, how stupid do you have to be.
Some guys I know decided they've had enough of bullshit and simply got an ultrasound for themselves to play with. It doesn't take 6 years of med school to do a decent doppler coronary artery exam. You simply need enough practice and access to rudimentary literature (and a modicum of intelligence). When you have the tool in your basement, you can get more hands-on time in a month than a resident gets in a year. Of course it helps if you're an engineer and can troubleshoot things and fix them when something breaks.
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