If We Told You That, We Would Have to Shoot You

http://www.whattofix.com/blog/archives/2010/06/if-we-told-you.php#more

by dpatru • 16 years ago

74 26 16 years ago

You live in a country where medical people of any sort (doctors, medical suppliers, etc) can be sued without scientific evidence that they harmed anyone. They will face trial with a jury having no ability to evaluate scientific evidence and who will make a decision based on who is more sympathetic. The plaintiff's lawyer may pretend to be a psychic and still be awarded millions of dollars rather than being laughed out of court (http://www.nytimes.com/2004/01/31/politics/campaign/31EDWA.h...).

Is it any surprise that everyone involved goes out of their way to avoid any hint of possible legal liability?

sliverstorm• 16 years ago

A million times yes. I am convinced many of the issues with systems everywhere in America could be fixed by less frivolous litigation.

megamark16• 16 years ago

My best friend is in the middle of his residency and this is what I hear from him A LOT.

Sukotto• 16 years ago

Certainly we want to reduce/eliminate frivolous lawsuits. The (really hard) problem is finding a good way to do so.

mattmaroon• 16 years ago

I don't think that's quite accurate. They could be improved, certainly, but tort reform would still leave our healthcare system woefully overpriced and underperforming. The amount of money it costs is trivial compared to lifestyle choices like being overweight.

ErrantX• 16 years ago

It seems crazy that modifying the machine doesn't invalidate any legal claim if it goes wrong (aka a warranty)

jbooth5• 16 years ago

Medical tort costs in 2007 were 30 billion and have been increasing at about 5% a year for the last 10 years (http://www.towersperrin.com/tp/getwebcachedoc?webc=USA/2008/...)

Meanwhile, medical costs are more on the order of 2 trillion and have been increasing by over 15 % a year for the last 10 years.

I don't think liability is really the main cost driver here. I'd look at profits first. $2k to do a sleep study? How much work could that possibly be? And then they insist on another one? Not to mention the whole PCP -> specialist -> other specialist to get a frickin piece of plastic. Everyone got a piece there.

orangecat• 16 years ago

The question is how much unnecessary expense is incurred trying to avoid legal liability.

yummyfajitas4• 16 years ago

I don't recall claiming torts were the cause of all medical inflation. I claimed torts were the cause of Daniel Markham being shuffled from sleep study to sleep study and of him not being allowed to hack his own medical device.

Also, your argument is specious since it completely ignores the cost of unnecessary medicine performed in order to ward off lawsuits. For example, a lawsuit fearing doctor might order unnecessary tests and procedures with little medical benefit but, but which the doctor can point to in court and say "look, I did the best I could".

flogic• 16 years ago

I think the problem is systemic. If you look at any one part of the system, you wind up saying "that's out of whack but it's only a small percentage." The problem seems to be that those small percentages are compounded.

Avenger42• 16 years ago

This was posted a couple of days ago... can't find the link though.

Here it is: http://news.ycombinator.com/item?id=1471123

Zak• 16 years ago

This is pretty problematic. The government and legal system don't seem to view taking responsibility for your own health as a legal right. I don't care that some people would do stupid things. A big "you shouldn't do this without a doctor's supervision" note is really all that should be required.

frossie• 16 years ago

I wish people would think outside themselves for a bit. Is every person who has self-diagnosed with Dr Google right? I am sure doctors have seen a bunch of people that are waving some printout that says "I have X, I need Y! Stat!" and are totally wrong. I personally don't blame them for wanting to go through the tests.

landyman• 16 years ago

I know a couple of doctors who have said that people come in saying "I have X, I need Y".. they called it "Googleitis". There are some times when they are right, but many times that they are wrong.

I agree that the tests should still be performed to take care of that problem. I also strongly agree that "requiring referrals" and having to go to 3 or 4 different doctors to get a test, diagnosis, prescription, and often times, another test just to make sure is terrible. Each time, I need to schedule appointments, wait, go to another doctor, wait, etc. It seems like what should take a week to do is stretched out in to 6-8 weeks, and I have to pay for it every time, even with Insurance.

michaelbuckbee• 16 years ago

It's actually an even deeper problem that people self-diagnosing through Google, as diagnostic tools increase in sophistication and decrease in cost you can potentially find "issues" that never existed before.

Take CT scans: if you took a random sampling of people, gave them a CT scan and then had an ortho doc look at the result 30% of the scans would show an "abnormality", but almost none of the patients would end up actually needing spine surgery.

Similarly with apnea, almost everyone has some sleep apnea, but not everyone needs a CPAP, etc.

yummyfajitas4• 16 years ago

This is simply innumeracy, in particular an inability/unwillingness to use Bayes rule.

shabble• 16 years ago

My startup is working in exactly this field; building a small embedded tag which can be linked to the data port of a variety of clinical devices, allowing data to be offloaded into a electronic patient record or external database.

We've had a bit of trouble getting protocols out of the manufacturers, but generally the hospital department in change of device maintenance (here, Medical Physics) will have access or can request it for datasheets, protocol specifications, and almost everything you'd want.

Not sure they'd be too happy providing it to a random patient though, whereas we have a working relationship with a few local hospitals.

I also recently underwent a sleep study for sleep apnea, and after having waited around 4 months for the test, it will now be another 5-6 before the specialist can review my results and make a diagnosis. Chances are any sort of CPAP will require another test for calibration and the like as well :/

I'm highly tempted to do as described in this article, and take one of the office test devices, a Nonin XPod http://www.nonin.com/OEMSolutions/Xpod and do a bit of night-time data logging of my own. Having worked with those devices, I quite like their very simple serial packet format, which is standard RS232 serial, and fully documented on the public datasheet on their website.

erikstarck• 16 years ago

Recommended reading: Andy Kessler, The End of Medicine: How Silicon Valley (and Naked Mice) Will Reboot Your Doctor.

There are startup opportunities hidden here!

terra_t• 16 years ago

I dunno, these patient narratives have a way of driving me up the wall.

It seems like just about everybody who can't cope has "Obstructive Sleep Apnea" these days... Enough that I'm starting to wonder if it's not just fashionable, but contagious.

If We Told You That, We Would Have to Shoot You

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