In­dus­try needs to fo­cus on tech­nol­ogy, treat­ments that add value

Modern Healthcare - - COMMENT -

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.

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