Topol and Teirstein: The Click and Rub Show

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Episode #4: Why is medicine resistant to change?

Oct 29, 2009 13:30 EDT


Medicine is frequently slow to adapt to change. In this philosophical exchange, Drs Topol and Teirstein seek to explain the phenomenon by examining evidence-based medicine, direct-to-consumer advertising, hectic schedules, general conservatism, randomized trials, physician incentives, and pay-for-performance.





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Jul 29, 2009 11:30 EDT



Your comments
Episode #4: Why is medicine resistant to change?
# 1 of 4
November 8, 2009 06:44 (EST)
jerdei
Not medicine, but people involved are slow-reacting. Not sufficient continuous education, conservative financing policy, providers legal safety, inadequate scientific, financial and administrative motivation are the reasons. The weight of factors listed is changing from country to country.
# 2 of 4
January 25, 2010 05:22 (EST)
Angel
One quick oint of disagreement. Not  all physicians started outpatients infusion programs for CHF drugs for profit. We never charged for infusion as chemtherapy or in any other way. We never charged for an office visit or any physician fee for our paitients attending the clinic. The drug was paid by the insurance and we absorbed the cost of the equipment and personnel. In fact we lost money and we knew that were probably going to. I am disappointed with the generalization made. Many of the measures to improve pt. comfort in advanced CHF lack sufficient evidence; diuretics is a good example. Some of us attempted to improve symptoms when our patients were failing maximal evidence proven therapy and did not qualify for transplant, surgery or devices. We thought that close contact and judicious use of standard therapy in this setting could improve quality of life. Our experience suggested that, the randomized trials did not. We felt we could provide a step before hospice. Not everyone was out to make a buck.
# 3 of 4
February 7, 2010 09:22 (EST)
Gerard
How has the PLATO study with Ticagrolor inflenced Scripps re Platelet testing?
# 4 of 4
June 2, 2011 07:55 (EDT)
fuad
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About the Click and Rub Show
theheart.org brings you a freewheeling and unconventional exchange on the latest cardiology news and events through the eyes of thought leaders Drs Eric Topol and Paul Teirstein from Scripps Translational Research Institute.

We value the diverse opinions of our readership (that includes you!) -- share your thoughts by writing them in the comments box at left and stay tuned for new shows, posted on a monthly basis.