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June 08, 2005
Arnold Kling has a series of well-reasoned pieces on health care spending here. In the latest one, he discusses the fiscal dangers of what he calls "activist medicine," which he defines in this way:
Activist medicine means undertaking procedures that have a low probability of affecting the final outcome.
This definition disturbs me somehow. Three problems in my mind. First, there's usually going to be a lot of uncertainty about the estimate of the probability. There may be a low estimate, but with wide confidence bands.
Second, the history of technological change suggests that sometimes only experience and a lot of fiddling and experimentation can convert a weak innovation into a strong one. Labelling a medical innovation as "activist medicine" prematurely could be the kiss of death.
Third, there's a lot of things that people could do for their health which have a high probability of affecting final outcomes, which they don't do. I'm not sure what to make of that, but I think it's important.
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And this is why we have to continue to strive to have physicians be independent professionals, which the emphasis on profesionalism.
We should continue to pay physicians high fees not for their specific knowledge (much of which can be programmed into a computer anyway), but for their wise and sound judgment. It's only that sound judgment which can distinguish between wasted treatment and life-enhancing treatment.
Let's do what we can to keep the business "requirements", financial incentives, and bureaucratic red tape out from between the patient, the physician, and a positive health outcome.
-- Jack Krupansky
Posted by: Jack Krupansky at June 8, 2005 01:08 PM
Here is what I think about activist medicine: doing something to improve the odds is all for the better. Actually "activist medicine" is neutral, rather than positive or pejorative.
Posted by: Dan at January 25, 2006 12:07 PM