Tuesday, July 29, 2014

Keeping up with the Joneses











Barry Carol said...

To me, the term “keeping up with the Joneses” suggests trying to show that by buying a new car or new and better clothes or joining a country club or whatever proves that I’m as well off, in a material sense, as my neighbors are. In other words, it’s all about status and the outward perception of wealth.

The mentality behind the robot acquisition is likely different. The hospital that buys one after a nearby hospital does may be motivated mainly be a fear of losing business if it doesn’t. This could happen because either rainmaker surgeons direct more of their business to the competing hospital or because patients perceive the competing hospital as more modern and likely to provide better care. So, even if the hospital CEO and trustees don’t think it’s a good idea to buy one, it may do so anyway because they think sustaining the hospital’s business model depends on it even if medical outcomes are no better and costs are higher. I think the whole dynamic highlights the need to do everything possible to ensure that patients have accurate information about the cost and efficacy of medical technology and the treatment alternatives available to them.

nonlocal MD said...

Barry, I think this very thing happened at Paul's hospital while he was CEO - correct me if I'm wrong about the motivation, Paul. These pressures are hard to resist, which even more points to the necessity for the profession to assert some leadership, advocating for limited rollouts in a few academic centers while the device/procedure is studied. The AMC's could be chosen by lottery or a rotation.(I am speaking off the top of my head here, but there are many ways to get control of this out-of-control situation without regulators becoming involved.)