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0 pointsmfer4y ago0 comments

In the book The innovator's prescription: a disruptive solution for health care by Clayton Christenson, there are some good analysis of where the complexity and problems come from in the current US medical system.

A lot of it has to do with size and the complexity that goes along with it. So, as hospitals get bigger, do more, and increase in size and complexity these issues become worse.

The economics math even mirrors factories... a factory that can build 100 things compared to one that just produces one thing.

The book was enlightening, even though many of the time frames called out in the book were wrong. Disrupting medicine is a lot harder than something like technology.

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mikkergp4y ago· 2 in thread

I think this alludes to it, but it's one thing mentioned in one of Atul Gawande's book is that in India they have hospitals that focus on one thing:

https://www.businessinsider.com/inside-indias-no-frills-hosp...

So like a 2000 bed hospital just for heart surgeries. Like you're saying, the more a heart surgeon specializes, the better they are at it and the cheaper they can do it. Better Outcomes for less money.

21434y ago

Yes there are hospitals in India that cater to a specific aliment. For instance, eye hospitals, cancer centres, hospitals that cater to pregnancy, childbirth and neonatology etc.

> Like you're saying, the more a heart surgeon specializes, the better they are at it and the cheaper they can do it. Better Outcomes for less money.

Not necessarily.

1. A heart surgeon is going to be doing heart surgery at more or less the same frequency regardless of whether the hospital they're at handles only heart patients or not. Wouldn't they?

2. I doubt if anybody here considers them cheap. Yes it's probably cheaper than in the US, but still it's rather expensive. But then again, since life is priceless, ...

mikkergp4y ago

At a 2000 bed facility though, you could specialize in specific types of heart surgeries. At a general hospital you're probably more likely to take on a wider variety of heart procedures. It's not just experience, but experience in specific procedures that can dictate outcomes:

https://www.reuters.com/article/us-healthcare-quality-surger...

Maybe cheap is the wrong term, but less expensive? I mean $800 may be expensive but certainly it's better than more?

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