Friday, August 13, 2010

Algorithm! Who Could Ask For Anything More?

Algorithms come up in medicine a lot. The idea is that, if a patient has x symptom, or y disease, then studies show, and the treating doc should perform, A, B, C et seq. True, as with any prescription based on statistics and populations, for most, but, obviously, not for all. So, a good algorithm is better than a bad doc, but neither is it sufficient to guarantee a good doc, who'll recognize outliers and deal differently with them.

Sometimes an algorithm makes a sort of sense. An orthopedist who does nothing other than total joint replacements, for instance, and his/her operating room team, will do them better, safer, more reliably, than a doc who does them maybe twice a month along with everything else. So, you're smart to ask the guy how often he does them. More is better. But you also need a doc referring you to said orthopod who considers whether or not you're a nail before referring you to a guy with a hammer, even if he/she's very, very good with one. Another argument for decent primary care at the heart of the health care system, and a reordering of the system to value cognition as much as procedure.

Which answers the perennial question:
Algorithm! Who could ask for anything more?

No comments: