August 2009


When I first became a doctor, exploratory surgery was commonplace. Today, we don’t do it anymore. Innovations in imaging have created immeasurably surer, safer, faster ways to pinpoint the source of a patient’s problem. Similarly, advances in surgical techniques have shrunk most multi-inch incisions, multi-week hospital stays, and multi-month recovery times to mere fractions of what they were just a few short years ago.

I mention this because—amid all the furor over national healthcare reform—commentators seem to be paying so little attention to the pivotal role of innovation in medicine.

Setting aside issues of political polarization, I think it’s safe to say that most people would want everyone who needs care to be able to get it, and that most would also want to see costs brought under control. But I suspect many assume it’s impossible to achieve both of those at once—and that’s where the dire scenarios take flight.  

In my eyes, innovation holds the key to avoiding “either/or.” There’s growing evidence that higher quality care typically lowers costs, for instance by avoiding complications and repeat hospitalizations. And that’s not even to mention the vast promise of science. On the horizon are new generations of vaccines. New possibilities of averting, or at least slowing, degenerative conditions. New strategies for conquering addiction. The list goes on and on.  

Academic medicine is at the heart of innovations like those, and I think that very fact should inspire us to redouble our commitment to the important work we do.  I also hope that rule-makers will strive to lower the hurdles that keep sound innovation from rapidly reaching patients and families, and that the national debate will factor in not only the costs of health care per se, but the far wider costs of disease—the suffering it causes and its toll on people’s ability to lead full, productive lives.