We should so hope but often that it is just not the case.
Laparoscopic surgery took medicine by storm 20 years ago but some new technologies of great value are slow to be adopted, such as simulation for teaching procedures rather than learning by practicing on the patient. Sometimes it is because the old way is “the way we have always done it” and sometimes it is because those holding the purse strings just do not appreciate the underlying value. Laparoscopic surgery got patients out of the hos…
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Added by Stephen C Schimpff on December 16, 2009 at 5:20pm —
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I was recently invited to present my thoughts on the Future of Medicine, based on my book of the same name, to the worldwide medical affairs group at Becton Dickinson, the giant medical device and diagnostics company headquartered in Franklin Lakes, New Jersey. Their senior vice president for medical affairs, Dr David Durack, requested that I review the basic megatrends developing as a result of the scientific advances from genomics, stem cells transplantation, vaccines, pharmaceuticals, medical…
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Added by Stephen C Schimpff on December 14, 2009 at 9:36am —
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In fact, healthcare reform is not about healthcare; it is mostly about paying for medical care for the uninsured and only somewhat about the rising costs of medical care. I use the term medical care here to emphasize that today American “healthcare” is all about treating disease and injury and very little about promoting wellness and preventing illness. The reforms being proposed are about addressing the financing of medical care but not the quality, the safety or the way that healthcare will be…
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Added by Stephen C Schimpff on December 12, 2009 at 3:41pm —
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This sounds logical but there are frankly amazing advances in medicine that are around the corner no matter what “reform” occurs. These advances are related to our national commitment to basic science and to engineering and computer science developments and their translation to clinical care. The National Institutes of Health, research organizations such as our medical schools, the pharmaceutical and biotechnology industries and the medical device industry are constantly bringing forth new knowl…
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Added by Stephen C Schimpff on December 11, 2009 at 9:53am —
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American medicine must change - and the change will be both substantial and difficult to achieve but change is critical if we are to have a well functioning healthcare system that affords all of us safe, quality care at a reasonable cost in a customer-focused manner. Today there are many misconceptions about healthcare reform - misconceptions about who will have access, how much it will cost, who will pay the bills, whether it will benefit those who currently have insurance, whether there will b…
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Added by Stephen C Schimpff on December 9, 2009 at 10:01am —
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As we watch the reform movement in Washington, we see and hear so many misconceptions. A current one relates to mammography. A few weeks ago guidelines were published in the prestigious Annals of Internal Medicine stating, in effect, that women between ages 50 and 75 with no history of breast cancer in their family and normal mammograms to date could probably switch from annual to biannual exams. And women between ages 40 and 50 probably did not need to get mammograms as had been previously reco…
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Added by Stephen C Schimpff on December 7, 2009 at 9:44am —
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In appropriating funds for the new Walter Reed National Military Medical Center and the new Fort Belvoir Community Hospital, Congress determined that the military should receive only “world class healthcare” but did not define the meaning of the term. When the Health Systems Advisory panel of the Defense Health Board described in the previous blog was assembled, it decided that its first order of business was to establish a benchmark for world class. After much discussion, research and debate, a…
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Added by Stephen C Schimpff on August 2, 2009 at 4:23pm —
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A very important reason for medical care cost escalation has to do with our own personal behaviors. We are a country of people who are overweight --one-third are overweight and one-third or more are frankly obese --, under-exercised, poorly fed from a nutritional perspective and highly stressed. And it gets worse each year. Even children have progressively declining physical activity from about three hours per day at age nine to less than an hour by age fifteen. And this will correlate to obesit…
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Added by Stephen C Schimpff on July 31, 2009 at 9:08am —
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Last fall I was asked by Maryland Senator Benjamin Cardin to join a group evaluating whether the new Walter Reed National Military Medical Center [WRNMMC], when completed in a few years, would be “world class.” The group, a subcommittee of the Defense Health Board, met multiple times to learn about the plans and develop a report for Congress. The report is now available at http://www.health.mil/dhb/meetings/NCR%20BRAC%20HSAS%20Report%20-%20Final.pdf . Here is a brief summary. The Base Realignmen…
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Added by Stephen C Schimpff on July 26, 2009 at 3:23pm —
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The switch from acute to complex chronic diseases and the wide variation in care patterns are closely related. It is the complex chronic diseases that need the most attention and hence are most expensive to treat. But as a country we have long had the tradition of the independent, autonomous practioneer in the community taking care of us. This was fine for acute illnesses. The physician could either treat you him or herself or else would refer you to a particular specialist for needed care. Mayb…
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Added by Stephen C Schimpff on July 20, 2009 at 10:00am —
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Recently Conrad Cyburn posted a note about the approach of Kaiser to keep costs down while quality high. They do a good job of avoiding the variations in care that exist across the country and which are part of thereason that caare is both expensive and not as good as it could or should be. There are wide variations in care expenditures from geographic region to region. One might assume that those regions with higher expenditures reap better health but that is simply not the case. Unfortunately,…
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Added by Stephen C Schimpff on July 16, 2009 at 10:13am —
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I appreciate the comments to my earlier post on the state of America's health care delivery system. We have incredible medical advances, of the type often referred to on MedTecIQ, but if they cannot be dellivered to the right people at the right time, then they are not being fully utilized to best advantage. One pressing need is to recognize the marked shift in disease prevalence from acute illness to chronic illnesses that has occured over the years; it is a real…
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Added by Stephen C Schimpff on June 29, 2009 at 2:14pm —
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We Americans like to pride ourselves as having the best healthcare system the world but unfortunately that is not the case. We have a medical care system, not a healthcare system. We give lip service to prevention and spend only about 3% of our $2 trillion in medical expenditures on public health. By many measures we do not rate favorably compared to many of the other industrialized societies. As citizens we have behaviors that are driving more and more illness, illnesses that at chronic, comple…
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Added by Stephen C Schimpff on June 14, 2009 at 8:04am —
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The future of medicine has some bright spots. One medical megatrend relates to the electronic health record. President Obama is aggressively pushing the electronic health record [EHR]. It will be a major improvement to medical care and to patient safety over time. But there are two major problems that need to be overcome before the EHR will ever be fully functional – interoperability and physician documentation. By interoperability I mean that each of the companies that produce the software do s…
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Added by Stephen C Schimpff on April 9, 2009 at 10:46am —
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