{"id":3705,"date":"2010-06-18T22:45:54","date_gmt":"2010-06-18T22:45:54","guid":{"rendered":"http:\/\/zmetro.com\/?p=3705"},"modified":"2010-06-18T22:45:54","modified_gmt":"2010-06-18T22:45:54","slug":"the_velluvial_m","status":"publish","type":"post","link":"https:\/\/www.zmetro.com\/?p=3705","title":{"rendered":"THE VELLUVIAL MATRIX"},"content":{"rendered":"

Atul Gawande<\/a>: <\/p>\n

Half a century ago, medicine was neither costly nor effective. Since then, however, science has combatted our ignorance. It has enumerated and identified, according to the international disease-classification system, more than 13,600 diagnoses\u201413,600 different ways our bodies can fail. And for each one we\u2019ve discovered beneficial remedies\u2014remedies that can reduce suffering, extend lives, and sometimes stop a disease altogether. But those remedies now include more than six thousand drugs and four thousand medical and surgical procedures. Our job in medicine is to make sure that all of this capability is deployed, town by town, in the right way at the right time, without harm or waste of resources, for every person alive. And we\u2019re struggling. There is no industry in the world with 13,600 different service lines to deliver.


\nIt should be no wonder that you have not mastered the understanding of them all. No one ever will. That\u2019s why we as doctors and scientists have become ever more finely specialized. If I can\u2019t handle 13,600 diagnoses, well, maybe there are fifty that I can handle\u2014or just one that I might focus on in my research. The result, however, is that we find ourselves to be specialists, worried almost exclusively about our particular niche, and not the larger question of whether we as a group are making the whole system of care better for people. I think we were fooled by penicillin. When penicillin was discovered, in 1929, it suggested that treatment of disease could be simple\u2014an injection that could miraculously cure a breathtaking range of infectious diseases. Maybe there\u2019d be an injection for cancer and another one for heart disease. It made us believe that discovery was the only hard part. Execution would be easy.<\/em><\/p><\/blockquote>\n","protected":false},"excerpt":{"rendered":"

Atul Gawande: Half a century ago, medicine was neither costly nor effective. Since then, however, science has combatted our ignorance. It has enumerated and identified, according to the international disease-classification system, more than 13,600 diagnoses\u201413,600 different ways our bodies can fail. And for each one we\u2019ve discovered beneficial remedies\u2014remedies that can reduce suffering, extend lives, […]<\/p>\n","protected":false},"author":2,"featured_media":0,"comment_status":"closed","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":{"footnotes":""},"categories":[3,5,32,40],"tags":[],"_links":{"self":[{"href":"https:\/\/www.zmetro.com\/index.php?rest_route=\/wp\/v2\/posts\/3705"}],"collection":[{"href":"https:\/\/www.zmetro.com\/index.php?rest_route=\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/www.zmetro.com\/index.php?rest_route=\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/www.zmetro.com\/index.php?rest_route=\/wp\/v2\/users\/2"}],"replies":[{"embeddable":true,"href":"https:\/\/www.zmetro.com\/index.php?rest_route=%2Fwp%2Fv2%2Fcomments&post=3705"}],"version-history":[{"count":0,"href":"https:\/\/www.zmetro.com\/index.php?rest_route=\/wp\/v2\/posts\/3705\/revisions"}],"wp:attachment":[{"href":"https:\/\/www.zmetro.com\/index.php?rest_route=%2Fwp%2Fv2%2Fmedia&parent=3705"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/www.zmetro.com\/index.php?rest_route=%2Fwp%2Fv2%2Fcategories&post=3705"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/www.zmetro.com\/index.php?rest_route=%2Fwp%2Fv2%2Ftags&post=3705"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}