Balancing Medicine and Marketing

Recently a friend who works in healthcare marketing told me that she will soon undergo a bilateral knee replacement.

I asked if she would be taking advantage of a recent development, knee implants designed especially for women.

After researching the possibility and discussing it with her surgeon, she found no advantage to the female-specific knee and decided that most likely the whole idea was based more on marketing than on medicine. There's truth in her conclusion. 

Two recent studies showed support for the idea that marketing (specifically the need to sell services and generate revenue) does influence medicine more than we would like to admit.  

A study of 377,000 patients in an HMO in Washington state found that between 1997 and 2006 the number of CT scans doubled and MRI scans per patient tripled. The average cost increased from $229 to $443. Instead of replacing older tests, the new ones were ordered in addition. Why? Better medicine? Protection from litigation? And perhaps the need to generate revenue to pay for all the new equipment.

The CyberKnife delivers radiation with amazing precision. Its first application was to treat inaccessible tumors in the spine and brain. Most recently, it's being promoted as an alternative to the many therapies for prostate cancer. The jury is still out on the effectiveness of treatment. However, we do know that each machine costs around $4 million dollars and urologists can receive approximately $1,200 in Medicare reimbursement for each procedure. "Unfortunately, it often comes down to the money," said Louis Potters, chairman of the American Society for Therapeutic Radiology and Oncology's Health Policy Council. "Prostate cancer is so common that it represents low-hanging fruit in terms of revenue opportunities."

Adoption and proliferation of new technologies is essential to bringing patients greater opportunities for recovery and restored productivity. It is also driven by the real economics required to support the advances.

Medical professionals and marketers alike need to maintain a delicate balance. Quality of care, cost control, hospital/clinic solvency and the overall integrity of America's healthcare system depend on it.

— Tom DeSanto

Sources: Reuters Limited, washingtonpost.com, photo: watership kennel/in knees of a solution