For some time medical economics has been the primary focus of my professional life. Medicine does not exist in a vacuum and touches every single person on Earth. This is an imperfect world and the need for medical resources exceeds the capacity to provide those resources. Now more than ever before it's critical that we find ways to provide better care at the lowest cost to the system possible.
Medical ethics has been a more personal fascination that is somewhat indirectly related to my professional life. Although in this imperfect world, we must somehow decide what patients receive resources and what patients go without. How do we get pharmaceutical companies to stop producing "like-me" drugs and provide incentive to provide revolutionary cures? How many proton pump inhibitors do we really need? How many isomers of an antidepressant do we need to patent? I'm not suggesting that pharma should not develop treatments for GERD and depression. I'm suggesting that these companies should stop investigating molecules that are so similar to already-approved molecules. I suppose in our capitalistic medical society, this competition is good.
We need some very drastic system reform. Medicine is about improving health and quality of life and finding cures. How do we insert this system into an economic system that is about "survival of the fittest" and "global competition" and "market forces"? Maybe it's time for consumer empowerment. What would happen if every patient that had been prescribed Prevacid suddenly "developed" a severe allergy to this product? And the same happened to all of those people taking Nexium, Aciphex, and Protonix? What if the consumers began to demand generic Omeprazole? Would Astra-Zeneca get the message that we don't need a look-alike drug that is the fifth in its class? Would TAP begin working on hard cures - like some real preventitive for HIV?
Earlier this week my Leadership 2015 group visited ETSU's Patient Simulator Lab. This was probably the most valuable and inspiring experiences of my entire life. This simulation lab is the best use of technology that I have ever seen. Doctors in training are able to perform complex procedures on exceptionally life-like simulators to hone their skills. "See one, do one, teach one" is still alive, but the residents' first experience no longer has to be on a living patient. Not only will patients be at less initial risk, but the student has much more ability to review his or her performance of the procedure and look for opportunities to improve. Extremely rare but critical cases can be simulated.
Sure, the technology is absolutely amazing. But as notable as the lab itself is its director. Dr. Martin Eason is one of the most intelligent men I've ever had the pleasure of meeting, holding an MD from the University of Arizona and a JD from the University of Louisville. In talking with Dr. Eason, you quickly realize that he takes his job very, very seriously. But he's able to talk to anyone and keep their interest alive. His motivation is obviously to provide better patient outcomes. A true innovator, Dr. Eason relayed stories of several improvised simulation devices - some even using fruit - to provide medical students at ETSU with the absolute best-available professional training.
I've never felt so confident about the quality of education that ETSU provides. University of Tennessee doesn't have this. Even Vandy doesn't have this kind of training. I want ETSU students working on me - not UT students!
Dr. Eason challenged all of us to spread the word about the simulation lab. The lab is available to practicing physicians as well as students. Every physician in the region needs to take advantage of this technology to improve his or her skills and abilities.
It's initiatives like the simulation lab and people like Dr. Eason that make me very proud of this region. And also make me think about med school as the graduate program of choice...
Posted by jguinn at January 20, 2007 7:35 PM