The Medical Arms Race: Da Vinci Surgical Robot Edition

(MoneyWatch)  One of the reasons healthcare costs keep rising astronomically is the fact that hospitals find it impossible to disengage from the medical arms race that's gripped the industry. Shiny and expensive new technology exerts a powerful influence on patients and doctors alike, drawing them to medical centers who can tout their state-of-the-art facilities -- whether or not those new cath labs or MRI scanners really do much to improve the quality of care.

At least, that's the abstract way of thinking about it. In a rare confession from the upper echelon of the medical-center establishment, Beth Israel Deaconess Medical Center CEO Paul Levy recently wrote at The Health Care Blog about his losing battle to stave off the purchase of a million-dollar Da Vinci surgical robot made by Intuitive Surgical:

Many months ago, I wrote about the da Vinci Robot Surgical System and expressed doubts about whether there was evidence to support the clinical efficacy of this equipment, as opposed to the marketing efficacy of the company selling it. Well, the time has come to graciously say, "Uncle!"

Without making any representations about the relative clinical value of this robotic system versus manual laparoscopic surgery, I am writing to let you know we have decided to buy one for our hospital.

Why? Well, in simple terms, because virtually all the academic medical centers and many community hospitals in the Boston area have bought one. Patients who are otherwise loyal to our hospital and our doctors are transferring their surgical treatments to other places.

Prospective residents who are trying to decide where to have their surgical training look upon our lack of the robot as a deficit in our education program. Prospective physician recruits feel likewise. And, these factors are now spreading beyond urology into the field of gynecological surgery. So as a matter of good business planning, concern for the quality of our training program, and to continue to attract and retain the best possible doctors, the decision was made for us.

And thus another attempt to hold the line against unproven but futuristic-sounding medical technology bites the dust. When even a hospital CEO has to bow to economic reality -- divorced though it may be from medical evidence -- any hope of reining in skyrocketing medical costs has to look faint indeed, barring a radical restructuring of the healthcare industry.

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