Wednesday, November 16, 2011

What If Committees Were Wrong?

About ten years ago an important committee recommendation from the American Heart Association came out to endorse the switch to automated defibrillators in hospitals taking out the "human" variability.   It was done on a hunch that these new devices would make their use speedier.   The problem is that evidence now shows that they save fewer lives.    It seems the decision by the brilliant experts was made without clinical research answering a crucial question: Did the new devices, when used in hospitals, produce better results than the old equipment?  Huh, seems like a valid question.   Now, a 1000 more patients die every year.   Interestingly enough, a quarter of the members of the heart association committee that recommended the automated defibrillators had business ties with manufacturers of the devices.  Pathetic. 

In my humble opinion, there are too many chiefs wanting to make the big decisions to justify their salaries.  Regardless of whether these members were paid off,  it bothers me that any new technology is just assumed to be better than what humans can do.  Isn't this really the trend we are seeing in all of medicine?  Idiotic and overpaid administrators, which are multiplying as we speak, want to get rid of the doctors and bring in the computers.  This AED example is just the kind of thing that happens when you do that.


Anonymous said...

Can we form a committee to answer your question? And, how much will I be paid to serve?

Anonymous said...

I am a non-cardiologist but have been taking ACLS since the 90s as a lowly EMT to teaching it for the last four years (even a Training Site Faculty for two hospitals for ACLS) and the new 2010 'evidence-based' guidelines are some of the most self-serving crap I have seen. All Cardiologists should be ashamed at this power/money grab. There are some good and reasonable changes but also lots of new insertions that basically amount to drumming up business.

Anonymous said...

Speaking of EMS:

From an emergency physician's perspective:

1) It USED TO BE that is was EMTs and Paramedics and Fire Chiefs were the best at wasting money, as their leadership adopted lots of things cause they seemed like good ideas despite lack of evidence....such as MAST pants in the 80s and 90s, intubating children in respiratory arrest with short home-to-hospital transport times, etc. We joke sometimes about big boys wanting big toys (not that emergency physicians are faultless, and by the way it is realized that to be an EMT or paramedic is a very difficult job!).

However, now cardiologists have joined the club.

2) It is like I tell our residents; "Just because you can does not mean that you should...."

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