Unnecessary Medical Procedures and the Dangers of Robot Surgery 130
Hugh Pickens writes "The LA Times reports that in a new report aimed at improving healthcare and controlling runaway costs, a coalition of leading medical societies has identified nearly 100 medical procedures, tests and therapies that are overused and often unnecessary. The medical interventions — including early cesarean deliveries, CT scans for head injuries in children and annual Pap tests for middle-aged women — may be necessary in some cases, but are often not beneficial and may even cause harm. 'We are very concerned about the rapidly escalating cost of healthcare,' says Dr. Bruce Sigsbee. 'This is not healthy for the country, and something has to be done.' Each of the specialty medical societies has provided a list of five procedures that physicians and patients should question about the overuse of medical tests and procedures that provide little benefit and in some cases harm. A 2012 report from the independent Institute of Medicine estimated total waste in the system at 30%, or $750 billion a year. 'Millions of Americans are increasingly realizing that when it comes to healthcare, more is not necessarily better,' says Dr. Christine K. Cassel." According to pigrabbitbear, it's the robots we should be wary of. He writes "'We are committed to helping victims of robot surgery receive the medical care and compensation they deserve. As both a lawyer and a licensed medical doctor, Dr. Francois Blaudeau has made it his mission to fight for the victims of traumatic complications as a result of botched robot surgery.' That's the opening salvo from the medical malpractice lawyers who run the slick fear factory of a website, BadRobotSurgery.com. According to the doctor-lawyers behind it—doctor-lawyers like Francois Blaudeau, MD, JD, FACHE, FCLM—'thousands of people have suffered severe and critical complications at the hands of surgical robots. In fact, 'robotic surgery has been linked to many serious injuries and severe complications, including death.'
Time warp? (Score:4, Informative)
Remote control surgery via endoscope, lapriscope or whatever has a human being driving a tool. There are no droids to be looking for.
There are robots and robots. (Score:5, Informative)
The robots in robot surgery are not the same as the robots in Isaac Asimov. A DaVinci robot has no autonomy at all, but is really just telepresence, an extension of the surgeon's hands and eyes. If anything goes wrong, it is the surgeon who is ultimately at fault (baring any mechanical or electrical problems, which I don't think they are alleging).
The BadRobotSurgery.com lawyers must know this; their web site sounds like it has all of he subtlety and morality of a Karl Rove political ad campaign.
And, of course, none of this really seems to have anything to do with unnecessary ,medical procedures.
Liability is backward-looking (Score:5, Informative)
No doctor wants to be on the stand in a courtroom and get asked:
"So, if you'd just done this one easy surgery, the dear deceased might be with us today?"
Inevitably, it ends up looking like the doctor wanted to "save money" by avoiding a $100 test or $500 surgery and that's what killed poor dearly departed.
Also, an order has suppressed evidence that the dearly departed was 500 lbs and smoked 4 packs a day while eating nothing but cheesburgers with bacon.
That kills the cost curve. So does the paperwork, which has hospitals hiring more paper-pushers than doctors and nurses. All of this stuff is backward looking, designed to avoid that one moment in trial where it sounds to 12 half-awake people that maybe the rich evil doctor just didn't care enough.
Re:Liability is backward-looking (Score:5, Informative)
Exactly this. I'm a fan of Doctor Grumpy, who's made his opinions [blogspot.com] pretty clear. There's always some doctor willing to testify that some test was obviously needed to find some rare condition with no visible symptoms. Those "unnecessary" tests are indeed necessary - not for the patient's safety, but for the doctor's.
Re:Robots good humans bad (Score:4, Informative)
Surgical 'robots' are pretty much entirely human operated cut-by-wire devices. "Waldos [wikipedia.org]" of varying sophistication and shape.
Very handy because you can, say, mount the business end of the device on something a lot thinner and more flexible than a surgeon's wrist, and avoid having to crack the patient's entire chest open, or apply a filter between the input and the output, to allow the surgeon to make otherwise impossibly tiny motions.
To the best of my understanding, much of the remaining challenge is machine vision/sensing. Unlike assembly line robots, surgical bots can't make assumptions about product uniformity(indeed, if they have you cracked open for repair, abnormality is the only safe assumption, though even clinically normal people can vary considerably) and failure to correctly distinguish between tissue types or other visual mistakes can have unpleasant consequences.
In terms of pure steadiness, strength, or repeatability, humans are pretty screwed; but getting robots to stop fucking up magnificently when something unexpected happens has continued to be tricky.
LOL unnecessary (Score:4, Informative)
Now even if I don't focus on the random testing they do which is massively overkill, they like to give me medicine like it's going out of style. I so far over the last 5 years have been switched on and off maybe 20 high power level nerve medications, all of which run a steep price tag and have a HUGE health risk attached. In some cases they will give me some super power new nerve med which will give me a new issue which they will order tests and new meds to treat!!!
I think my GP says it best 3/4 of the time, "Fuck off and shut up, If it's not causing at least a 7