Any time a healthcare innovation gains traction, the old guard screams “show me the data that proves this new thing is better!”
And then the press jumps in and starts trolling everyone because controversy drives clicks and page views and revenue, and trolling is today’s business model for the press.
Here’s the latest example:
Leapfrog, a group that rates hospitals, is going to start rating surgical centers. This is likely in response to a Kaiser Health News / USA Today investigative article “As Surgery Centers Boom, Patients are Paying with their Lives” that found since 2013, more than 260 patients died after care at centers that lacked appropriate lifesaving equipment, operated on very fragile patients or sent people home before they fully recovered.
I am 100% in support of data. Period.
But the real problem I have is with what the old guard defines as the gold standard. If the gold standard is today’s status quo, well, open up the flood gates of innovation because healthcare’s broken. So broken that the estimates are now ~210,000 people die from coming in contact with America’s healthcare system.
People don’t realize that hospitals are very dangerous places. They’re teeming with doctors that have every incentive to throw the gauntlet at you and do the maximum amount of things to you and on you. That’s how they make money and they can’t get sued for “overpracticing” and doing everything to protect themselves, even when the right thing to do is practice minimalist medicine. And the more they do, the more they find, and the more they find, the more they do. This all leads to overtreatment and its complications (aka “we’re sorry you died because we couldn’t stop ourselves from going down every single rabbithole we could drum up”).
So…innovations like lower cost surgical centers are designed to be a focused factory that does a lot of low risk procedures over and over to standardize care, limit what they do for you, and because of this, do procedures at far lower prices. Hospitals are like factories that can build anything. Surgical centers are like factories that are focused on building one simple thing and making it the highest quality they can at the lowest cost.
So when the old guard (and now the trolling press) begins to compare 260 deaths at surgery centers in the last 5 years with the 210,000 deaths (per year!) that occur in hospitals, I’d say surgical centers are an absolutely phenomenal innovation. Can they improve? Hell yes. I’m sure. We can all improve and we should constantly chase zero deaths due to medical interventions. But to define today’s status quo as the gold standard is completely flawed thinking. Just because it’s the devil you know doesn’t all of a sudden make it an angel to compare anything new to.