atw: Re: The decreasingly meaningful authoring experience
- From: "Brian Clarke" <brianclarke01@xxxxxxxxxxxxxxx>
- To: <austechwriter@xxxxxxxxxxxxx>
- Date: Fri, 10 Jun 2005 00:51:47 +1000
Hi Steve,
I was looking at population statistics. I do not regard a case study of one
person
or one firm in the health care industry as adding anything - except perhaps the
basis for some careful hypothesis generation; a case study of one can never be
used to test any positive hypothesis - it can only test a null hypothesis. [see
Popper]
One bloods testing lab's reducing staff says more about the paucity of its
management's marketing efforts. In earlier days, the doctor would have done a
very detailed history-taking and diagnostic work-up; now the doctor asks for
FBC
[full blood counts], U&Es [ureas and electrolytes], and other path tests, which
leads to more path labs required rather than fewer. But, if patients are going
to
be expected to pay for all these tests, that may be another countervailing
force.
The reason doctors don't do house-calls is purely economic. First, they have
more
diagnostic power available - all those tests - and the cynical observation that
'the
well person is one who has not been properly diagnosed yet'; this leads the
average patient to have raised expectations that an answer can be provided =
more demands on the doctor = less time available for prospecting. Second, the
amount doctors receive via bulk billing does not provide enough cover for the
life
style doctors are trained to expect. So, they gather together in clinics to
reduce
rent costs and to share the cost of a receptionist and other office services.
They
may choose to roster the role of being on-call - but they are more likely to
exploit a locum tenens service. The growth of the clinic has also ushered in
the
full medical centre where path lab tests are done on the same site. That is
oligopoly.
Case studies cannot be used for testing hypotheses - in spite of many journos'
trying to do so. While the introduction of new technology will affect
individuals,
the discussion has been about whether that always results in nett benefits. I
still contend that the introduction of new technology in the health care
delivery
field has yet to show an overall nett benefit in economic terms. I suspect that
because medicos operate under 'closed shop' conditions, they are, in effect,
acting as monopolists. Hence, the only economic beneficiaries of increased
technological input to the health care delivery field are the producers and
users,
rather than the end consumers.
Maybe in a few millennia, when the technology has been more fully
democratised, we may see the end consumer of health care delivery as the
beneficiary. Unfortunately, in Australia, we are following the American model
of the haves and have-nots, as distinct from the now almost defunct British
National Health Service and the similar New Zealand Social Security health
system.
However, the situations of cotton production in Australia and the world-wide
defence industry showing population-wide economic benefits from technologic
democratisation ... Hmmm. Wait a moment - I can think of one economic
advantage of the defence industry - poly-tetra-fluoro-ethylene. Is there
another waiting to burst upon our gaze? The recycling of mass-produced,
uranium-enriched, anti-tank projectiles for our new nuclear-fuel-celled motor
vehicles, perhaps?
Brian.
Steve said:
A specific example I shall provide again, despite still waiting for one,
this time in the industry you have chosen.
An acquaintance of mine, Rowan Letters, was quite concerned about his
employment stability about 5 years ago.
<snip>
His lab was downsizing. They had just brought a new blood analyser. It now
meant that instead of a few guys constantly running tests on batches for
several days, the machine would process the blood and produce results in a
few hours. Marvellous stuff. But, it meant they no longer needed the
headcount.
Rowan negotiated a deal and went interstate with them to a smaller lab.
Several staff voluntarily left (retired). They downsized because of an
investment in technology.
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