Healthcare Innovations

Debatable Access to Cancer Treatment

WSJ: Why We'll Never Cure Cancer. 2007-Oct-27, by Peter B. Bach

In the interviews surrounding the announcement about cancer death rates, most observers argued that more spending on research was urgently needed, to build on the scientific advances that have been made. That's right. We should also be spending more, much more, to ensure that scientific advances benefit patients.

When a new screening test is developed, we should make sure that patients find their way to doctors who can perform it. When a new targeted therapy is discovered, we should make sure the right patients get it. When a drug that can relieve a person's pain is proven to work, we should make sure it is sitting on every pharmacist's shelf. If we address these problems, we'll have a real reason to celebrate.

WSJ: We Need Uncomplicated, Inexpensive Cancer 'Tools'. 2007-Oct-31, by Michael J. Weber

All these procedures thus need to be viewed as "stop-gap" measures, while research on the molecular underpinnings of cancer allows the development of screening tools that are as inexpensive, sensitive and accurate as cholesterol measurements, and interventions that are as unproblematic as vaccines, antibiotics, and laser surgery.

Such advances in detection and treatment are possible. However, unless funding for medical research becomes a much higher priority in the Federal budget, they will not occur during our lifetimes.

The Innovator from West Virginia

Story taken from Medical Economics (http://memag.com) Publish date: Dec 15, 2006 by Robert Lowes, found at Primary Care One | News & Articles:

These days, the soft-spoken, but formidable family physician is mixing it up in the role of healthcare reformer. Three years ago, Vic Wood began advertising that his clinic would provide unlimited primary and urgent care for a monthly fee of $83 for an individual, $125 for a family. Wood immediately ran afoul of the state insurance commissioner, who warned him that he was operating as an illegal insurer, a felony punishable by up to five years in prison. For the next three years, Wood pushed for legislation—and got pushed back by the insurance-industry lobby—that would legalize his experiment. Now instead of prosecuting Wood, West Virginia is replicating his bargain-basement version of concierge medicine in a pilot program. The goal—to make healthcare more affordable in one of the poorest states in the nation.

To Wood, it’s all about removing the financial middlemen between doctor and patient, at least when it comes to primary care. "There are answers to the healthcare crisis that don’t involve insurance companies," he says.

The Status Quo Always Fights Back

Over at the Health Care Blog, Brian Klepper recently shared an amazing presentation he experienced at the Aspen Health Forum. Neen Hunt, executive director of the Lasker Foundation read a fascinating story about Dr. Charles D. Kelman, which was written and originally presented by Dr. Joseph Goldstein, Chairman of the Lasker Awards Jury, at the 2005 Albert Lasker Medical Research Awards Program in New York City.

I'm reprinting an excerpt here to focus on the incredible difficulties faced by any innovator such as Dr. Kelman in challenging the status quo in healthcare or any other industry. The more radical approach, the more likely the existing players will circle the wagons and try to keep you out.

If our society is truly dedicated to innovation--we keep saying we are--then we need to figure out a way to identify and prevent these situations. Dr. Kelman had to endure years and years of discrimination from his peers. Fortunately, he was an outgoing and successful professional with a strong "inner circle" of supporters. Maybe we should teach innovators how to find supporters the way he did.

The Health Care Blog: Aspen Report 3 - Removing the Blinders: Dr. Kelman's Wonderful Contribution2007-Oct-18, by Brian Klepper.

It is instructive to note that the vast majority of ophthalmologists viewed phacoemulsification as a radical procedure that totally challenged their conventional wisdom. They were shocked by Kelman’s audacity to discharge his patients on the same day of surgery and permit them to return to full activity on the first or second postoperative day. For many years, Kelman, the practicing eye surgeon without proper academic credentials, was treated with overt hostility by the established academic surgical community.

Largely owing to Kelman’s ingenuity, dedication, perseverance and inspiration, phacoemulsification has become not only the most common, but also the most successful, surgical procedure in history. Last year 3 million Kelman-type cataract operations were performed in the U.S. and 6 million worldwide. Kelman’s vision extended beyond the eye. Phacoemulsification was the first minimally invasive surgical technique, and it stimulated the development of other “keyhole” surgeries, such as fiber optic removal of the gall bladder, lumpectomy of the breast, and repair of vertebral discs.

Peek into Christensen book on healthcare

Harvard professor and innvoation guru Clay Christensen is working on a book on healthcare, and during his appearance last week at the Business Innovation Factory, we got a glimpse into what he's thinking.

Business Innovation Factory weblog: BIF-3 - Thursday Recap. 2007-Oct-11, by Steve Hardy

The reason health care is so expensive and inaccessible, he said, is because we have not allowed business innovation to complement it. His example revolved around how maladies are diagnosed and treated, noting that diagnosis and therapy can and should be separated because they function very differently.

License to Roam: BIF and Clayton Christensen. 2007-Oct-11, by Rachel Clarke

In [healthcare], the tech enabler is precise diagnostics.  Molecular medicine is just opening up, what we called type 2 diabetes is looking to be 20 different things.  At the level of our genes, it is very precise.  Over the next 20 years, it will change, being able to say you have this gives you the ability to treat effectively.  And then we need a new business model.  There are 3 generic types of a model; the first is a value shop, this is like consultants or advertising agencies.  The 2nd is a value chain and the 3rd is a value network,  In a hospital it is a value shop, for the diagnosis.  Then you move into the chain activities, to get an operations etc.  a chain works well for a standard process.  As everything is in a hospital the value chain gets overpriced and the value shop gets underpriced.  We need to break the connection.

Richard Fogoros book

Dr. Wes: Fixing American Healthcare. 2007-Oct-1, by Westby G. Fisher, MD

This book is a must-read for physicians, hospital administrators, government regulators, and policy pundits that want to understand the complicated interplays affecting our healthcare delivery in America today. It is refreshing that it offers a solution, not just a rant.

David E. Williams, WorldHealthCareBlog.org, 2007-Sep-24:

Fogoros makes a compelling case that the problem with our current health care system is covert rationing, which has profound corrosive effects. Once the problem is laid out, Fogoros proposes a solution that encompasses open rationing and is characterized by six key principles, one of which is that healthcare coverage must be universal.

Doctor Shortage

WSJ: Doctor Shortage Hurts A Coverage-for-All Plan. 2007-Jul-25, by Zachary M. Seward

The dearth of primary-care providers threatens to undermine the Massachusetts health-care initiative, which passed amid much fanfare last year. Newly insured patients are expected to avail themselves of primary care because the insurance covers it. And with the primary-care system already straining, some providers say they have no idea how they will accommodate an additional half-million patients seeking checkups and other routine care. "Health reform won't mean anything for the state's poor if they can't get a doctor's appointment," says Elmer Freeman, director of the Center for Community Health, Education, Research and Service in Boston.