On Monday 23 Jul 2007 7:42 pm, Shyam Visweswaran wrote: > These individuals and > entities have every right to gain monetarily from > their inventions along with the companies that > act merely as marketing conduits.
Interesting. I am seeing the manner in which inventor-surgeon and marketing company cooperate to make money in the case of some "advances". Some innovations are not necessarily beneficial or better, but are saleable because of some reason or other. Typically in surgery the proof that something is really good or even "better" may not be evident for 5, 10 or 20 years - because patients can theoretically come back with problems related to a surgical device sometime later in his life (or uncover a problem by dying). I have been watching the introduction of weird surgical implants for hernias and devices for other diseases that are literally being tested out on patients using compliant doctors in countries like India, with Indian doctor getting the implant at a fraction of the going rate in exchange for using a lot of it, apart from sweeteners like all expenses paid trips to various places. While many of these devices may not be unsafe, they may be of no extra benefit other than making money for one company over another. Other devices may prove to better, or a mistake. The marketing and hype makes patients ask for the "innovation" and creates a rush of doctors wanting using it without being particularly choosy about where it might work best or whether it will work at all. I think a type of cardiac stent was recently withdrawn from the US market when they started getting blocked - presumably leading to some deaths. I just wonder if one should really differentiate between the value of innovation for therapeutic benefit versus the value of innovation for getting a patent and making some more money. I am seeing the evolution of market driven medicine where patients demand treatment or investigation that is advertised. I find myself in a constant fight between the ethics I was taught and the risk of being declared obsolete for not blindly doing what's currently in fashion. As I get older I will probably change and just stop caring and merely follow fashion over surgical caution. That is what everyone wants and that is what doctors with lucrative practices must do. The role for ethical medicine is, in my view, gradually vanishing from India at least. shiv
