Industry needs to focus on technology, treatments that add value
Regarding the April 21 cover story (“Surgical-robot costs put small hospitals in a bind,” p. 12), if there were randomized, prospective trials demonstrating clear superiority of robotic techniques over conventional surgery, there would be an unambiguous rationale for the use of robotics. It would be a competing technology with a clinical benefit. However, except
for retrospective studies demonstrating a day or two advantage in length of stay, such evidence is lacking, and this technology has become a competitive tool for hospitals in terms of driving volume, which of course, (with the added expense of utilizing the technology without additional reimbursement), is the primary reason that hospitals
purchase it. When we compete for patients and the reimbursement that accompanies their treatments and procedures (rather than competing to see who can deliver the best care and outcomes), we perpetuate the morass that our healthcare industry has become. When we begin to compete on the value of the care that we deliver, we will
realize that procedures that cost the system (including patients) more without added benefit have no place in an efficient healthcare system.
Dr. Robert Lancey Norfolk, Va.