Monday, January 10, 2011

Another reason why Healthcare Costs are Soaring


Our department is trialling new machines this month. Our old machines are still functional but according to the manufacturer will not be serviceable in three years time.

Just before Christmas, I learned that we would be getting 8 new machines. As department head I was a little confused because no one had approached me about these machines. Worse I was told that we would have no choice about what machine it was and that we would not be able to trial the machine. The reason I was given was that money was now available for the purchase of these machines and it had to be spent now or it would be lost forever.

Worse still was that the machines that had been chosen for us were the Draeger Primus machine. Our department bought two of these a couple of years ago for use in Obstetrics. Unfortunately as I blogged about, these machines if unplugged have a 30 minute boot up which of course makes them unsuitable for obstetrics (or for anaesthesia in general for that matter). In addition they have a tiny work surface, do not have the modes of ventilation some of us have come to love and of course they have Draeger's annoying wolf-crying alarms.

About a year ago my predecessor was faced with a similar demand. Get new monitors or the money disappears. He replaced our perfectly good monitors with new monitors from Philips which have been disastrous.

I wasn't too happy about being rail-roaded into buying machines that I certainly didn't want and the rest of my department didn't want so after a few few phone calls my reasoning was thus: when if three years we actually do need new machines, what are they going to do? shut down the OR?. Of course not, the money will come from somewhere. I also got the strong impression that we were being railroaded into taking machines that somebody else had already rejected.

So I phoned up the lady who is in charge of purchasing these machines. She is as it happens a nurse who was in charge of the neurosurgical ORs at the Centre of Excellence when I worked there. I told her that we did not want the machines, that we realized that we were going to "lose" the money; that we did not care and that we would let the chips fall where they may. She just said, "I hope you know what what you're doing BH". I said I did.

One hour later I got a phone call from the same person, asking if I would be willing to trial a different machine.

BH 1 Administration 0.

Seriously though, in twenty years I have seen so much perfectly good equipment thrown out because the capital budget had to used up. Some new equipment has been an improvement over what we had before, quite a lot of new equipment has been a huge step backwards.

As an aside, it now difficult to find a machine that is not completely electronic, which of course makes them susceptible to software and hardware problems and of course a software glitch could easily disable an entire department's computers. This usually requires a tech from the company to come in from out of town. I long for the old mechanical machines with their simplicity and easy serviceability. I challenge anybody to prove that our newer machines are anymore safe than the old mechanical machines people of my vintage trained on.

2 comments:

burnttoast said...

And am I the only suspicious person who wonders "Is the manufacturers decision not to provide service/parts for previous models REALLY about patient safety?" Economic incentive that forces your customers to buy NEW is more likely. Wouldn't the auto manufacturers love that power?
And the budgeting process in hospitals is counterproductive. A million for a robot? Got it. Money to maintain fiberoptic scopes? You should have taken better care of them!!! (Fragile in best of hands.)

burnttoast said...

And am I the only suspicious person who wonders "Is the manufacturers decision not to provide service/parts for previous models REALLY about patient safety?" Economic incentive that forces your customers to buy NEW is more likely. Wouldn't the auto manufacturers love that power?
And the budgeting process in hospitals is counterproductive. A million for a robot? Got it. Money to maintain fiberoptic scopes? You should have taken better care of them!!! (Fragile in best of hands.)