Dude, who even knows.

10th January 2021

Link reblogged from argumate with 162 notes

I wasted $40k on a fantastic startup idea →

fockineh:

argumate:

“And that isn’t worth something? Prescribing better treatments?”

“Hmmmm,” she said, picking at her fingernails. “Not directly. Of course I always have the best interests of my patients in mind, but, you know, it’s not like they’ll pay more if I prescribe Lexapro instead of Zoloft. They won’t come back more often or refer more friends. So I’d sorta just be, like, donating this money if I paid you for this thing, right?”

I had literally nothing to say to that. It had been a bit of a working assumption of mine over the past few weeks that if you could improve the health of the patients then, you know, the doctors or the hospitals or whatever would pay for that. There was this giant thing called healthcare right, and its main purpose is improving health—trillions of dollars are spent trying to do this. So if I built I thing that improves health someone should pay me, right?

I spend quite a bit of time in healthcare improvement circles. It isn’t really a knowledge deficit problem, and pay-for-performance programs don’t seem to work either. They have a hell of a time getting doctors to use Choosing Wisely/Cochrane Reviews, and those are free. Changing the behavior of physicians and patients is actually really hard. 

I mean for one, yes professional autonomy is important to the professions. Seen in that light, healthcare analysts trying to tweak incentives to induce practicing doctors to act as desired have the same moral coding as assistant deans subjecting full tenured professors to evaluation schemes looking to bend their teaching in line with grand administrative plans.

For two, as a matter of survival that’s a strong instinct. Homeboy created a technology for synthesizing the sum of accumulated medical knowledge, patient demographics, and side effect considerations into recommendations for treatment! We have something in that role already! It’s a doctor! Even self-diagnosis tumblr couldn’t generate dose-response curves untrained.

Like, I could absolutely see the political coalition that would allow, say, nurse practitioners or pharmacists using this sorta thing with insurer-approved protocols to prescribe most drugs, with doctor-only limited to the stuff you really need regular evaluation while on, it’s not a boon to “physicians” understood collectively, it’s a threat

  1. depressed-changeling reblogged this from chaifootsteps
  2. chaifootsteps reblogged this from wordcubed
  3. cthulhubert reblogged this from wordcubed
  4. elancholia said: @theresponseblog Forgot about this, but: emphasis on “automatic”. A patient taking the initiative to seek a second opinion is a) not always doable, imposes a nontrivial cost on the patient and the health system, etc., and b) requires them to recognise the potential for a mistake in the first place. This option is already available, as you correctly note, and the problem clearly remains.
  5. wareware-wa reblogged this from bisphenol-a
  6. theresponseblog said: @elancholia you can get that without an app, it’s called “go see another doctor”
  7. superdrivel reblogged this from quoms
  8. awhiterose reblogged this from quasi-normalcy
  9. sang-the-sun-in-flight reblogged this from kontextmaschine
  10. elancholia said: [imagine this was a paragraph-break lol] Having a redundant safeguard (an automatic “second opinion” generator) seems like a clear improvement over the status quo. It’s not like there aren’t improvements to be made or errors to be caught, given how prominent medical error is as a cause of mortality, let alone the merely unhelpful or unpleasant errors that doctors make.
  11. elancholia said: Responding purely to this comment, not the article –
  12. fuckboysecurityllc reblogged this from homoluigi
  13. avaguelyfeminineradish reblogged this from pleasespellchimerical
  14. buisit2 reblogged this from quoms
  15. argumate posted this