I know this is a slog, but I am trying to compress about a zillion years (or that’s what it felt like) of graduate school and industry training into something that might be palatable (as it might be), but more important, useful, to anyone who wants to slog through it. I am a poor example of what should be a good product, considering the training I had. The errors in this endeavor all all mine and the good parts (if any) are because of lots of much more interesting people.
The freedom in that is I know already I cannot due justice to the phenomenal exeriences I was granted, though serendipity and outright good luck. This blog is just my outlet for saying thanks.
But you don’t get off the hook that easily, as I have to push on with the thinking and the examination of what it is that we do, as a culture, in persisting in the kind of involution described below.
If you think about the nature of our medical system, I think I am on fairly safe ground in asserting that on of the underlying aspects can be reduced to an economic argument, that therapies that converge on the suppression of symptoms, without addressing the underlying pathology, create an annuity for the industry of medicine. Hmmm.
Every chronic disease state becomes an annuity for the industry. Could that be true? An example? Okay. Here is just one.
FDA approves a technology of use on treating pain and edema after surgery. But so effective that technology is in other areas, Medicare (CMS) approves it for use in treating chronic wounds.
As an aside, even though Medicare says it is effective, the FDA precludes the companies from advertising it for that use.
Unfortunately, not an unusual position for companies to find themselves it, but that isn’t as important as what happens on the ground. I was one of the founders of such a company and we began to drive the therapy into places were it could help patients with chronic wounds, which often require special beds, pressure relieving surfaces, which help those patients as well.
One of our early users added the therapy to his program of renting these beds to nursing homes. As the therapy proved effective, he angrily accused us of reducing his ability to rent the beds, as the chronic wounds healed more quickly, so folks didn’t need the beds as long. He actually asked if we could make it ‘less effective.’ So maybe this is just a story, because it doesn’t have the names and the dates (oh, which it could). But doesn’t the whole idea make ‘economic’ sense? I’ll offer more objective examples as I go on. But just think about it. It isn’t a conspiracy, or a plan that anyone person has, but it is the outcome of the incentives. That’s what an anthropologist behind the curtain can see.
The freedom in that is I know already I cannot due justice to the phenomenal exeriences I was granted, though serendipity and outright good luck. This blog is just my outlet for saying thanks.
But you don’t get off the hook that easily, as I have to push on with the thinking and the examination of what it is that we do, as a culture, in persisting in the kind of involution described below.
If you think about the nature of our medical system, I think I am on fairly safe ground in asserting that on of the underlying aspects can be reduced to an economic argument, that therapies that converge on the suppression of symptoms, without addressing the underlying pathology, create an annuity for the industry of medicine. Hmmm.
Every chronic disease state becomes an annuity for the industry. Could that be true? An example? Okay. Here is just one.
FDA approves a technology of use on treating pain and edema after surgery. But so effective that technology is in other areas, Medicare (CMS) approves it for use in treating chronic wounds.
As an aside, even though Medicare says it is effective, the FDA precludes the companies from advertising it for that use.
Unfortunately, not an unusual position for companies to find themselves it, but that isn’t as important as what happens on the ground. I was one of the founders of such a company and we began to drive the therapy into places were it could help patients with chronic wounds, which often require special beds, pressure relieving surfaces, which help those patients as well.
One of our early users added the therapy to his program of renting these beds to nursing homes. As the therapy proved effective, he angrily accused us of reducing his ability to rent the beds, as the chronic wounds healed more quickly, so folks didn’t need the beds as long. He actually asked if we could make it ‘less effective.’ So maybe this is just a story, because it doesn’t have the names and the dates (oh, which it could). But doesn’t the whole idea make ‘economic’ sense? I’ll offer more objective examples as I go on. But just think about it. It isn’t a conspiracy, or a plan that anyone person has, but it is the outcome of the incentives. That’s what an anthropologist behind the curtain can see.
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