Delicious LiveJournal Links for 6-20-2010

[andrewducker]

• The future of medicine
  (tags: medicine healthcare speech complexity organization science)
• How what we know and what we act on aren't always the same.
  (tags: belief knowledge psychology)

Comments

[autopope.livejournal.com]

The "future of medicine" commencement speech is dangerously misleading from a British viewpoint -- a lot of what he's describing are side-effects of the American system of commercial medicine. (That's not to say we don't have problems over here, but the ramping of costs is largely a side-effect of the way healthcare is delivered over there. Lots of spurious and very expensive diagnostic tests to pad the bills), a grotesque lack of attention to preventitive medicine, and devil take the [uninsured] hindmost.

[andrewducker]

Absolutely. The article is all about systems, and the USA's systems are noticably more varied and worse than the ones in the UK, from my understanding. I believe that standardised checklists are becoming more and more common over here.

[drdoug.livejournal.com]

There is a huge shift to what's called 'protocol-based care' and 'guideline-based care', across the sector internationally. The drivers in different health systems are different (and the UK and the US perhaps illustrate extremes of insurer-led drivers and the UK government-led drivers), but there are broad similarities.

The idea is that a group of suitably-qualified people develop a protocol or guideline for a particular situation, based on the best available evidence, which usually also includes some measures of cost/benefit analysis (often by proxy). Then health workers simply follow those instructions, unless they have a good reason for departing from the usual process, which they are typically obliged to account for.

There are all sorts of problems with it, but as a tool for deploying very focused intelligence across a huge range of people it's not bad, IMO.

[andrewducker]

Yup - my Dad's been involved in some of this stuff (as a Doctor who was involved in lots of committee work) and another friend is working in this area at the moment, and was showing me videos of how pilots work with checklists and guidelines to try and avoid error-situations (and how they go horribly wrong sometimes).

[drdoug.livejournal.com]

It's also flat wrong in places - e.g. "There is no industry in the world with 13,600 different service lines to deliver." My guess is that most industries in the world have more than that, unless you have a very narrow definition of what constitutes a single industry and a very broad one of what constitutes a single service line. Certainly narrower than 'medicine' and broader than 'distinct code in ICD-10, disregarding subclassifications'.

Although I suppose if he meant 'with precisely 13,600 - no more, no less' it's almost certainly true.