5 ms·

A few things to consider: 1) You can't turn an operating room immediately. A 1hr surgery requires significant prep time _AND_ cleaning time. These rooms are us

A few things to consider: 1) You can't turn an operating room immediately. A 1hr surgery requires significant prep time _AND_ cleaning time. These rooms are used for many different kinds of surgeries — changing everything takes time. To make matters worse, each surgeon has their own preferred set up, and it needs to match that. 2) All medical supplies are expensive in part because your body is pretty sensitive, and you need to be careful about what's in there, but also because doctors almost always have _COMPLETE_ control over what equipment they use ... including screw and tool brands. This means that hospitals have little-to-no leverage to get lower prices. This is particularly true for implants & other complicated equipment. 3) Insured people subsidize the uninsured.

angersock 13y ago
So, it sounds like we need to stop coddling the doctors and standardize on a particular set of tools.
- gaius 13y ago
  And you thought emacs vs vi was bad...
- epmatsw 13y ago
  The issue with that is that no hospital is willing to be the first. Hospital: We're going to lower costs by not letting doctors choose their equipment. Talented surgeons: Welp, don't want to work there. Patients: Why would I go to the hospital that doesn't have any of the good surgeons?
  - angersock 13y ago
    So, have a deal that says "Hey, if you want to be able to receive Medicare/Medicaid payments, you have to standardize tools." All the hospitals will say "Wow, holy shit, alright", and the surgeons will have to play ball--because a surgeon without a proper OR is basically just a butcher or barber. EDIT: Please explain why this is a bad idea instead of just downvoting.
    - drdoc 13y ago
      As an anesthesiologist, this is a bad idea for various different reasons. There are a numerous reasons why a physician needs the tools that he needs. The type of procedure, the type of patient and the familiarity of the equipment. I routinely intubate patients with a particular type of tool because that is what I feel most comfortable with and I have trained with. Yes, I can intubate with the myriad of other devices but there is that 1 out of a 1000 chance (slim but not unrealistically slim because I do >1000 intubations a year) that I cannot intubate you and you need to have a tracheostomy or worse, you die. Some may argue that we should all train with the same equipment, but even then, what about inherent differences in the physician or the patients. Maybe where I trained, all my patients had large tongues and I need a particular blade more often so I became better skilled with that or maybe my hands are just better with a particular blade.
      - angersock 13y ago
        If I dropped a Linux admin off at a shop which didn't have emacs on their boxen and he refused to work because he might accidentally screw up a config file, he'd be laughed out of the joint. If I dropped a plumber off at a job site and she didn't have a particular type of ergonomic monkey wrench she'd grown accustomed to and said she couldn't do the job, she'd be mocked endlessly. If I dropped a line chef off at a kitchen and they didn't have their favorite knife available and they held up orders for a whole night, their boss would fire them. ~ This custom bespoke medicine nonsense is increasingly seeming to be just that: nonsense. Sure, there's this .1% chance that you might screw up an intubation, but that seems to be more of an issue of bad training than bad equipment. As far as your point about differences in patients or physicians: that's a cop-out. Part of being good at what you do (as a dev, as a maker, as a person) is being flexible enough to make do and succeed. In a system which costs as much as ours does to people who simply can't afford it, we (as a society) cannot afford to cater to the whims of overspecialized professionals.
        milesskorpen 13y ago
        In all your examples, you aren't dealing with a person's health or (potentially) life. The risk-benefit calculation changes (and people become, understandably, somewhat irrational) when the stakes get that high.

angersock 13y ago

So, it sounds like we need to stop coddling the doctors and standardize on a particular set of tools.

gaius 13y ago
And you thought emacs vs vi was bad...
epmatsw 13y ago
The issue with that is that no hospital is willing to be the first. Hospital: We're going to lower costs by not letting doctors choose their equipment. Talented surgeons: Welp, don't want to work there. Patients: Why would I go to the hospital that doesn't have any of the good surgeons?
- angersock 13y ago
  So, have a deal that says "Hey, if you want to be able to receive Medicare/Medicaid payments, you have to standardize tools." All the hospitals will say "Wow, holy shit, alright", and the surgeons will have to play ball--because a surgeon without a proper OR is basically just a butcher or barber. EDIT: Please explain why this is a bad idea instead of just downvoting.
  - drdoc 13y ago
    As an anesthesiologist, this is a bad idea for various different reasons. There are a numerous reasons why a physician needs the tools that he needs. The type of procedure, the type of patient and the familiarity of the equipment. I routinely intubate patients with a particular type of tool because that is what I feel most comfortable with and I have trained with. Yes, I can intubate with the myriad of other devices but there is that 1 out of a 1000 chance (slim but not unrealistically slim because I do >1000 intubations a year) that I cannot intubate you and you need to have a tracheostomy or worse, you die. Some may argue that we should all train with the same equipment, but even then, what about inherent differences in the physician or the patients. Maybe where I trained, all my patients had large tongues and I need a particular blade more often so I became better skilled with that or maybe my hands are just better with a particular blade.
    - angersock 13y ago
      If I dropped a Linux admin off at a shop which didn't have emacs on their boxen and he refused to work because he might accidentally screw up a config file, he'd be laughed out of the joint. If I dropped a plumber off at a job site and she didn't have a particular type of ergonomic monkey wrench she'd grown accustomed to and said she couldn't do the job, she'd be mocked endlessly. If I dropped a line chef off at a kitchen and they didn't have their favorite knife available and they held up orders for a whole night, their boss would fire them. ~ This custom bespoke medicine nonsense is increasingly seeming to be just that: nonsense. Sure, there's this .1% chance that you might screw up an intubation, but that seems to be more of an issue of bad training than bad equipment. As far as your point about differences in patients or physicians: that's a cop-out. Part of being good at what you do (as a dev, as a maker, as a person) is being flexible enough to make do and succeed. In a system which costs as much as ours does to people who simply can't afford it, we (as a society) cannot afford to cater to the whims of overspecialized professionals.
      - milesskorpen 13y ago
        In all your examples, you aren't dealing with a person's health or (potentially) life. The risk-benefit calculation changes (and people become, understandably, somewhat irrational) when the stakes get that high.