Hope or Hype: The Obsession with Medical Advances and the High Cost of False Promises

By Richard A. Deyo; Donald L. Patrick | Go to book overview

5

Social Hazards
What We Lose by Uncritical Use
of New Treatments

We're eating pancakes some nights as it is. I said to my husband, "what are we
going to do, sell the house so we can pay health insurance?" —Trish Patafio,
homemaker1

THE MEDICAL world adopts new treatments with blinding speed. This is especially true if doctors perceive the new treatments as "cutting edge" and if the reimbursements are good. In 1981, doctors performed 26 liver transplants in the United States. Just six years later, 1,182 were performed. By 2001, over 5,000 liver transplants were being done each year.2,3 In most years, about 10 percent of the two hundred top-selling drugs are new.2 When a new operation for patients with emphysema was described at a medical meeting in 1994, it set off a frenzy to provide the new operation. An article based on the presentation appeared in January 1995. By October 1995, the operation had been performed on over a thousand Medicare patients and was being offered in at least thirty-seven states.4

But as we've seen, some medical advances get adopted before we know enough about them. In many cases, this is related to successful marketing, professional enthusiasm, and public demand. In contrast to the traditional lament, "How do we get people to use new approaches?" we think today's challenge is how to slow down and critically evaluate the

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