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Paul Levy, CEO of Beth Israel Deaconess Medical Center in Boston, has an illuminating post up today explaining why his hospital just bought a $1.5 million da Vinci Robot Surgical System. First, he links to a post from a few months ago on the technology. There's very little data to support the claim that it offers better outcomes, he said, but it's being adopted anyway. Why? Well, it increases "market share." The CEO of the Ford Health System in Detroit said "We've seen double-digit increases in the number of prostate cases performed since we introduced the da Vinci Surgical System." And the manufacturer web site offers "three examples of hospitals that have captured market share with the da Vinci Surgical System." In other words, more surgeries, all of which are incredibly expensive. "In short," concluded Levy, "what we have here is a new technology, with no proven advantage in terms of clinical results, that is rapidly moving forward in hospitals because urologists and their hospital administrators have become convinced that their market position depends on owning this robot." He forgot to note that this is a ROBOT and thus AWESOME (though also likely to turn on its surgeon masters and kill us all), but still: Good points all around.
Today, Levy offered up another post, this one entitled "Uncle." He writes:
Without making any representations about the relative clinical value of this robotic system versus manual laparoscopic surgery, I am writing to let you know we have decided to buy one for our hospital. Why? Well, in simple terms, because virtually all the academic medical centers and many community hospitals in the Boston area have bought one. Patients who are otherwise loyal to our hospital and our doctors are transferring their surgical treatments to other places. Prospective residents who are trying to decide where to have their surgical training look upon our lack of the robot as a deficit in our education program. Prospective physician recruits feel likewise. And, these factors are now spreading beyond urology into the field of gynecological surgery. So as a matter of good business planning, concern for the quality of our training program, and to continue to attract and retain the best possible doctors, the decision was made for us.Ladies and gentleman, your American health care system!So there you have it. It is an illustrative story of the health care system in which we operate.
