> I think we were pretty successful at finding these kinds of mismatches between medical science and medical practice. By their nature, though, these kinds of solutions are hard to scale to reach lots of people.
I’m curious about the cause of this. It seems like this is relatively straight forward to scale: Simply use marketing to get them to be more standard practice at hospitals and doctors offices.
There’s two potential reasons I can imagine off the top of my head, but would really like to hear from you why these were so hard to scale.
1. They weren’t hard to scale, but they were hard to make money with. If this is the case, maybe a non-profit could do it?
2. The fact that they weren’t already standard practice meant that most of them had some other reason not to scale (the treatment was weird, it added extra liability, etc).
Was there some other reason these types of interventions wouldn’t scale?
Simply use marketing to get them to be more standard practice at hospitals and doctors offices.
A lot of money is spent on pharmaceutical and medical device marketing, and it’s a crowded field. Occasionally someone who’s already very high profile like Atul Gawande can successfully promote things like the idea of having checklists at all, but in a substantial share of cases these quickly become distorted by hospital internal politics.
Giving a person a hypnotic induction before an operation means that you need to use less painkillers to sedate people and wounds heal a bit better.
Yet, it’s not a standard procedure. I know two anesthetists who actually have the necessary hypnosis skills but who still don’t use them when they sedate a patient for an operation.
I talked with one of them in more detail about it. According to him he has 15 minutes with a patient and in those 15 minutes burocratic documents have to be filled. There are additional pressures from his employer to be even faster.
In the end he hated his job and quit being a doctor. It wasn’t possible for him in the enviroment in which he was to take 30 minutes to sedate a patient with added hypnosis even when he was confident that this would improve clinical outcomes.
It’s even harder in cases where the relevant skills aren’t there and they would need to hire additional expertise.
I spoke with a person who did new business development at a Big Pharma company a few times. According to him doctors generally only adopt new ways of treatment when there’s something in it for the doctor.
> I think we were pretty successful at finding these kinds of mismatches between medical science and medical practice. By their nature, though, these kinds of solutions are hard to scale to reach lots of people.
I’m curious about the cause of this. It seems like this is relatively straight forward to scale: Simply use marketing to get them to be more standard practice at hospitals and doctors offices.
There’s two potential reasons I can imagine off the top of my head, but would really like to hear from you why these were so hard to scale.
1. They weren’t hard to scale, but they were hard to make money with. If this is the case, maybe a non-profit could do it?
2. The fact that they weren’t already standard practice meant that most of them had some other reason not to scale (the treatment was weird, it added extra liability, etc).
Was there some other reason these types of interventions wouldn’t scale?
A lot of money is spent on pharmaceutical and medical device marketing, and it’s a crowded field. Occasionally someone who’s already very high profile like Atul Gawande can successfully promote things like the idea of having checklists at all, but in a substantial share of cases these quickly become distorted by hospital internal politics.
Giving a person a hypnotic induction before an operation means that you need to use less painkillers to sedate people and wounds heal a bit better.
Yet, it’s not a standard procedure. I know two anesthetists who actually have the necessary hypnosis skills but who still don’t use them when they sedate a patient for an operation.
I talked with one of them in more detail about it. According to him he has 15 minutes with a patient and in those 15 minutes burocratic documents have to be filled. There are additional pressures from his employer to be even faster.
In the end he hated his job and quit being a doctor. It wasn’t possible for him in the enviroment in which he was to take 30 minutes to sedate a patient with added hypnosis even when he was confident that this would improve clinical outcomes.
It’s even harder in cases where the relevant skills aren’t there and they would need to hire additional expertise.
I spoke with a person who did new business development at a Big Pharma company a few times. According to him doctors generally only adopt new ways of treatment when there’s something in it for the doctor.