Podcast on the End of Medicine
Do you ever wonder if your doctor is really doing a thorough job when you go in for your yearly physical? I do. You go in and he/she hits your knee with a rubber hammer, runs a few blood tests and asks about any symptoms--all the time, checking their watch to make sure they can get to the next patient. What if a tumor is growing inside you or your arteries are clogging up faster than last night's dinner in the drain of your kitchen sink? Wouldn't you want to know in advance so that treatment could be started immediately before your life is threatened? Well, soon you might.
Today we are joined by Andy Kessler, the author of the new book, The End of Medicine : How Silicon Valley (and Naked Mice) Will Reboot Your Doctor.
He talks to us about new technology (including his exerience with having a virtual colonoscopy), how Silicon Valley can assist in bringing healthcare prices down to scale, and how socialized medicine might be an impediment to living longer.
You can listen to the podcast by clicking here or via subscribing to iTunes. There's a lo-fi version for dialup here, and a complete podcast archive here. You can leave any suggestions or comments below.
Today we are joined by Andy Kessler, the author of the new book, The End of Medicine : How Silicon Valley (and Naked Mice) Will Reboot Your Doctor.
He talks to us about new technology (including his exerience with having a virtual colonoscopy), how Silicon Valley can assist in bringing healthcare prices down to scale, and how socialized medicine might be an impediment to living longer. You can listen to the podcast by clicking here or via subscribing to iTunes. There's a lo-fi version for dialup here, and a complete podcast archive here. You can leave any suggestions or comments below.
posted by Helen at 9:11 AM
25 Comments:
Good stuff on how the establishment is trying to keep people from independent medicine on the Medical Lies section of the
liecommittee.com
(weird Catholic stuff on other parts of site, weird. New approach, focus on liecommittee.
We already know from DNA studies that the whole idea of "addiction" is superstition.
And yet despite knowing this for at least the last three or four years the idea persists and is not being refuted in the popular press.
Science does not change belief.
Is Addiction Real?
I have been documenting this for four years. The NIDA has come out in support of the science (at least in part). You have to wonder why I am a lone voice in the wilderness.
My theory: belief is stronger than science. Even for those not favoring the drug war.
Helen,
I am a big fan of the likes of Ray Kurzweil and the idea of accelerating returns, but the problem I have with this as applied to medicine is that our capability to utilize technology tends to be limited by our concrete knowledge, and in that regard it seems that the development of technology seems to be outpacing our ability to utilize it.
Granted, I haven't read Kessler, and I will isten to the podcast on my morning commute- but I would be pleased if you and Glenn could address that sort of concern with any guests you might have on similar topics in the future.
Dr. Helen,
I haven't listened to the podcast yet, but I do have an opinion.I know, shocking! Technology is excellent and in some cases better than the majority of doctors (research on dx MI confirms this and many Emergency Departments are using computerized metrics to decide who gets admitted now). The best doctors, however, will almost always beat technology. They use technology to help, but either subconsciously or with some heightened awarenesss simply pick up what others don't. That is why the best surgeons, the best in any specialty are worth the extra $$. They have a gift.
Speaking of Doctors with a gift, here is one:
A well known secret
I've been suffering from rheumatoid arthritis for more than 5 years now. It took more than 5 doctors over a six month period to diagnose it as such. After knowing that there is really no cure, I opted for aggressive treatment but paid the price in terms of side effects. I had liver damage, high blood pressure, cataract symptoms (from prednisone) and most recently, persistent headaches and infections. Right now, I'm seeing about five specialists including a neurologist to determine the root cause of these problems. I have also tried acupuncure and homeopathy but nothing seems to work. I know that something is not right with my body as I have lived with it all my life. My confidence in doctors has been diminished but I have the will and faith to overcome the problems.
Somehow, the medical profession has been so specialized that their views have been so narrow and misses the goal of a person's total well-being.
There is a drug with an unmatched safety record (aspirin is more dangerous) that is useful in treating arthritis.
Unfortunately it is illegal.
There is a theory that annual physicals are of no value whatsoever
Keep this stuff up! And you have a great radio voice, Helen.
M. Simon,
I have noticed that your posts seem to often be off topic and focused on illegal drug use and ptsd. While those thoughts are interesting, and I have followed them on your blog on occasion, they sometimes detract from the flow of ideas on this blog.
Just some feedback.
Trey
This sounds very encouraging, and I do hope Kessler's predictions are borne out. I plan to read his book. But years of experience as a medical consumer tell me not to be optimistic.
When a medical procedure has evolved to the point of being very routine, the likelihood of satisfactory diagnosis and treatment is good. But as soon as the patient presents a problem that doesn't quite fit the practitioner's template, the odds go down drastically. Most of the time, the underlying issue is not just uncertainty on the part of the medical people but lack of curiosity. Who wants to take the time to consider something new when the waiting room is full of other, possibly easier, problems?
Will the application of technology address that?
"Somehow, the medical profession has been so specialized that their views have been so narrow and misses the goal of a person's total well-being."
The way my dad's urologist and his cardiologist both failed to spot his case of pneumonia four days before it put him in the hospital. Medicine relies on the doctor's ability at pattern recognition. Technological enhancements (expert systems and the like) will help avoid mis- (and "missed") diagnosis.
Re: "how socialized medicine might be an impediment to living longer."
I was pondering this yesterday as I read about the controversy in the UK over taking Namemda (an alzheimer's drug) off the list of covered medicines in their national health plan.
As the caregiver of an elderly relative who has Parkinson's and dementia, I wonder what the value of extending life beyond any quality is. And what constitutes quality? Our patient complains a lot just because it's always been her nature to do so. But in reality, she doesn't have the cognitive ability to really recognize how much she's lost. So it's OUR quality of life that suffers, not hers. Our life quality shouldn't be the issue in making medical decisions for her. In socialized medicine, it tends to be the relative cost vs. benefit to society rather than the individual that is primary.
anonymous 4.17. was it worth the problems you have now to cure arthritus. which may not have been cured anyway.
but isnt there a possibility that people will worry themselves to death, turn into hypochrondiacs.
my bp is normal, my heart rate is 72 at rest, and as for cholesterol, well cholesterol does change due to exercise and nerves.
ignorance is bliss, the problem is that medicine tries to work on a one size fits all, when i am different than you, so why should i have the same problems as you.
i live in the UK, with national health service.. we have one of the best health services on the planet at the moment.
machinery, anti human technology, will lead to a complete dehumanisation of people, i would rather speak to a doctor, face to face than have them rely on machines for diagnosis, rather than using HUMAN judgement. might as well get rid of all doctors and let machines work on humans( worse case scenario, but )
Just throwing out some random thoughts and observations:
anonymous 4:17-
Have you looked into bee stings? There seems to be some anecdotal evidence (maybe more, I haven't researched it) that this is effective. I remember seeing a segment on a woman that ran over a bee's nest on a riding mower and was bitten a number of times and although she was in trouble at the time, her problem arthritis went away. (Note that when they use stings therapeutically I believe they are controlled and in small numbers.) Also rule out hemochromatosis, it sometimes is a hidden cause of arthritis.
Dr. Helen-
If healthcare costs is an issue you are interested in you may want to look into how the AMA's control of the number of medical schools and the number of practicing doctors contributes to high health care prices. This is a good (and eye-opening) article on the subject:
http://www.mises.org/story/1547
A lot of conservatives, including some libertarians, blame tort litigation for high healthcare costs. I tend to think this is incorrect, as tort litigation is one of the few ways of policing physicians and the healthcare industry.
generally-
A kind of "creeping collectivism", often built on some blatant "for the children" emotional manipulation, seems to be seeping into many facets of our society, including healthcare. This is dangerous because it tends to cheapen the individual and individual rights. It's also dangerous because in many cases the emotional manipulation can be ratcheted up to make it sound good.
For example the Nazis imprisoned and sterilized innocent Roma (gypsy) men for the "safety" of women and children. "For the children" and "better safe than sorry", and all that. Blatant collectivist nonsense to justify pathological criminal behavior, but it sold well to the crowds then, and would likely sell well to the crowds now.
Anonymous 6:57 brought up a serious point with the article about ama's control of the number of medical schools and doctors. It's definitely a kind of monopoly of service that these doctors have been performing for the past few generations.
When you actually consider this possibility you end up realizing how they artificially raise their wages by making doctor shortages. Doctor shortages seem a part of life to the average westerner and nobody really asks why that is the case? Why do we have to steal doctors from overseas and still not use them most of the time. Well read this article and you will find out why.
Anon 9:11 am wrote: "When you actually consider this possibility you end up realizing how they artificially raise their wages by making doctor shortages."
I WANT my docs to make stupid money. Because I want very talented and intelligent people as my physicians. High salaries attract high intelligence. It is a competition thing. And I want there to be LOTS of competition to get into med school, I want the med school to be hard work. All that competition and hard works makes for better doctors.
People are not born Marines. But a few can be transformed into Marines. Same thing with doctors as far as me and my family are concerned.
I also wonder if we steal doctors from overseas or they come here to practice medicine and make some darn good money while doing it. As long as are good doctors and their training is impecable, I welcome them.
Trey
but equally stupid doctors get the same wages as highly intelligent, and there are more stupid people than smart..
trey-
You want competition in the marketplace too. Your "boot camp" analogy sounds nice and all, but there's still lots of incompetence, negligence, malfeasance, poor service, arrogance, etc.
Plus it's not a certainty that salaries would drop dramatically. Malpractice insurance, for example, might actually go down because there is a larger pool of insured parties. Also, health care is a major cost for nearly everyone, so lower prices would tend to make everyone wealthier, including physicians. In any case its hard to tell how various variables would react without some more research. But in most cases everyone is better off when distortions and manipulations are taken out of the market.
Mercurior wrote: "but equally stupid doctors get the same wages as highly intelligent, and there are more stupid people than smart."
Is that accurate? I thought that intelligence parsed out nicely into a fairly normal curve, meaning that there are as many stupid as smart.
But, I agree with your point. My dad, a physician, used to say that the top third of med school made the best researchers, the middle third made the best doctors, and the bottom third made the most money.
I just want there to be LOTS of competition involved in getting into med school so that the bar is set high enough to accept bright folks.
Trey
it all depends on where you put the intelligence curve, if you say only people with 147 iq are smart, then there are a lot of people not as smart, if you put the level at 160, theres more not as smart.. i have known some doctors who couldnt tie their own shoe laces, they are the pill pushers, and others who do nothing for throat infections as they dont beleive in pills. but then there are brilliant doctors who are wonderful,
and i agree with you, you have to have bright people with open minds rather than those that follow fashion of the week.
Listened to the podcast and hate to burst Andy Kessler's bubble but the healthcare market as it exists today does not operate like any other segment of our economy. It is utterly insensitive to price except in those areas of retail medicine...cosmetic surgery and lasik eye surgery. Medicare reimbursement drives EVERTHING. It is estimated that only 25% of procedures done have strong science behind them showing efficacy. I think that the definitive book on our current healthcare system is "Saving Lives, Saving Money." Another good one is "Overdosed America." Both of these books address what is currently driving the system in sightly different ways.
The key IMHO is that the consumer needs to have a stake in the cost of healthcare. Until that happens, all progress will be at the margins.
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