Wide-eyed new-technology-in-town health care coverage

Another example of fawning coverage of medical technology.

Another example of obsequious news on the DaVinci robotic surgical system, about which I’ve written earlier. (In fact, an earlier post just this week about the President playing with a robot at the Cleveland Clinic.)

A story in The Oklahoman reports on a university medical center’s new DaVinci robotic surgical system for prostate cancer.

It failed to report on the limited evidence to support this approach. The U.S. Agency for Healthcare Research & Quality states that there hasn’t been enough research to know how this approach compares with others.

It also failed to look at the apparent burgeoning medical arms race in Oklahoma City – just for prostate cancer much less anything else. One center is bragging about its latest generation robot. Another center is bragging about its even more expensive proton beam therapy.

Wouldn’t that be a good story?

How local newspapers deal with issues of medical technology assessment, of community ascertainment of need, of resource allocation. of costs, of evidence is vital to public understanding of why we spend more than any other country on health care without the outcomes to show for it. Stories can educate or they can advertise. This one falls in the latter category.

(Hat tip to Craig Stoltz, from whom I borrowed the “wide-eyed new-technology-in-town” phrase, and who helped with the review of the story in question.)

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Patrick Driscoll

July 29, 2009 at 12:18 pm

Gary, Agreed. The adoption of new technology too often is accompanied by fixation on features rather than cost-effective benefits. Since I have been covering medical technology developments (too many years), I have harped on the idea that medical device solutions to healthcare problems are imperfect, but they are often available here and now while the “perfect” solutions offered by biotechs (e.g., “rational therapeutics”, gene therapies, etc.) continue to remain out of reach. My predilection is for solutions to disease where either no solution currently exists or where existing alternatives are inadequate. So, while I favor device technologies, and even some expensive ones involving capital equipment (e.g., gamma knife, laparoscopy systems, etc.), I do so out of the “lack of adequate alternative” consideration. When I see DaVinci systems discussed with wide-eyed infatuation, I am just flabbergasted that they aren’t recognized for what they are — big money pits draining the healthcare system. That isn’t to say that there aren’t clinical applications that meet the necessary criteria — no alternative treatment or offering a significantly improved outcomes that consider the added cost. There are complex procedures (mostly neuro, in my opinion) that seem to fit this.
Without producing clinical benefits that either don’t exist otherwise or are simply more cost effective than alternatives, expensive new technologies just don’t belong in this system.