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This article explores the intersection of healthcare, technology, and costs in today's society, delving into the impact on quality of life, the importance of specialized medical care, and the challenges faced in decision-making processes. It discusses the evolution of medical specialization, the rise of technological imperatives, and the fallacies surrounding cost control and quality of care. Additionally, it addresses the complexities of funding technology in healthcare, drug decision-making processes, information systems, and the future of healthcare technology.
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HEALTH CARE TECHNOLOGY 1 MARCH 2005 KATHARINE C RATHBUN MD
COSTS • MONEY • TIME • LABOR • PAIN • INDEPENDENCE • LOVE
HOW MUCH IS YOUR LIFE WORTH? • YOUR MONEY, TIME, ETC • SOMEONE ELSE'S • SOCIETY’S
HEALTHY WORKER EFFECT • THE EMPLOYMENT PROCESS SELECTS FOR PEOPLE WHO ARE HEALTHY • THERE IS NO HEALTHY PERSON EFFECT ON BEING ALIVE • THERE USED TO BE
LIFE EXPECTANCY / DISABILITY • 1966-1997 LIFE EXPECTANCY ROSE 2.8 YEARS • DISABILITY FREE YEARS PROJECTED TO DECLINE BY 7.3
CAUSES OF DISABILITY • SAVING LIFE MAY MEAN INCREASED NUMBERS ON DISABILITY • ONLY SAVING BABIES CONTRIBUTES TO A DECLINE IN DISABILITY FREE YEARS
TECHNOLOGIC IMPERATIVE • HAVE STATE-OF-THE-ART TECHNOLOGY • USE THIS TECHNOLOGY AT EVERY OPPORTUNITY
MEDICAL SPECIALIZATION • SPECIALTY BOARDS WERE SET UP IN THE LATE 1940’s • MEDICARE AND HEALTH INSURANCE IN THE 1960’S • ALSO A TECHNOLOGIC IMPERATIVE
PUSH FOR SPECIALIZATION • PAY MORE • BUY EQUIPMENT • ADDS PRESTIGE • WON’T HIRE GENERALISTS • ADVANCED PRIVILEGES • PEOPLE HAVE BEEN TAUGHT TO DEMAND SPECIALISTS
PUSH FOR PRIMARY CARE • THIS IS GIVEN LIP SERVICE • LOWER PAY AND PRESTIGE • DENIED PRIVILEGES • WORK UNDER SPECIALIST SUPERVISION • GET HAND-ME-DOWN FACILITIES AND EQUIPMENT • USED AS GATEKEEPERS TO THE SPECIALISTS
QUALITY OF CARE FALLACIES • TECHNOLOGY ASSESSMENT • DECISIONS ABOUT TECHNOLOGY ARE ABOUT QUALITY OF CARE • MORE SPECIFIC IS BETTER
COST CONTROL FALLACIES • UNNECESSARY TESTING/CARE • OLDER PHYSICIANS HAVE MORE INAPPROPRIATE ADMISSIONS • DRG’S WITH REDUCED PAYMENTS • OUTPATIENT VS INPATIENT • CERTIFICATE OF NEED • COMPETITION
FUNDING TECHNOLOGY • MERGE WITH OTHER PROVIDERS • OBTAIN MANUFACTURER SUPPORT • BECOME A DEMONSTRATION SITE • BECOME A SERVICE CENTER • PONZI SCHEMES
DECIDING WHICH DRUG TO USE • DRUG MANUFACTURERS • DOCTORS IN PRACTICE • DOCTORS IN TRAINING • VIOXX VS IBUPROFEN
CLASSES OF DRUGS • OVER THE COUNTER DRUGS • PRESCRIPTION DRUGS • SCHEDULED DRUGS - NARCOTICS • SUPPLEMENTS
INFORMATION SYSTEMS • ALL THE USUAL PROBLEMS • HIGHLY IDIOSYNCRATIC INFORMATION • HIGHLY “TECHNICAL” INFORMATION • HIPPA
TELEMEDICINE • STORING AND TRANSFERRING INFORMATION • ISOLATED DOCTORS • GENERALLY ACQUIRING DATA IS THE PROBLEM NOT READING IT
THE FUTURE • IT STILL TAKES 9 MONTHS TO MAKE A BABY