In Canada: according to emergency pediatrician Dr Brett Taylor, there's many practices in canadian healthcare that are not cost-effective: many new technological procedures and protocols are not only costly, they're also less effective than traditional measures. He argues for targeted research into just exactly which procedures are effective enough to be worthy of funding, and which are not. He also states that Canadian healthcare now is a zero-sum game: to achieve savings somewhere, procedures elsewhere must be cut. "Peak dollar" has been passed...we can no longer do more with less.
Comments?
Agreed that MDs and administrators both need to make smarter, evidence-based choices about which procedures to use and fund. However, his notion that "we can no longer do more with less in healthcare" is true only in the context of actual medical procedures. A fully-electronic provincial or national medical record system, which Canada does not currently have, will allow the healthcare system to avoid unneeded services and in fact "do more with less".
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Here's a comment from Ralph Y:
ReplyDelete"His specific points I generally agree with, but the concept of not funding innovation makes me pause. I don't think this approach would work in the long-term simply because we cannot restrict innovation based on our initial assessment on how useful it would be - many of our greatest discoveries were accidents after all. However with a tight budget, perhaps more targeted, socially-applicable research is what we need to do on a short-term instead of research that only emphasizes new treatment technologies without considering 1) costs and 2) effectiveness."
Comment from Mike Y:
ReplyDelete"I agree with Yan's comment on how an electronic health record system is really one important way we CAN "do more with less". And from reading the article, it seems that the author is more concerned about how we apply newfound technologies and research findings rather than funding the research itself (so innovative research may not be at risk). If we can take new research findings and put them through a solid filter that includes follow-ups of evidence-based research before advertising/hyping them up to the public, a lot of money could be saved. However, that principle might only be applied in certain situations (ie. the new MS treatments have not gone through sufficient evidence-based research yet, but many people are turning to them because they have few other options in a life-threatening situation)"
Agreed - one thing though: regarding "put them through a solid filter that includes follow-ups of evidence-based research before advertising/hyping them up to the public"....what if the scientists can't wait that long because they need to publish what data they have to get funding? In essence, it's a funding-system issue, eh?
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