A long time ago, but in a galaxy pretty darn close to here, there were medical schools and universities that got onto studying the concepts in basic and applied science of medicine. They flourished after WWII; then abruptly changed. What are they good for now?
Since the NIH & NSF funding collapse, research has shifted over to the private corporation, and the home-run drugs.
Just to put in perspective, the entire National Science Foundation budget in 1985 was less than the National Science Foundation budget dedicated to pre-college science education in 1980. It’s continued to dwindle.
Yesterday, I mentioned that NIH/NSF tends to come out with cheap treatments, and corporate funding comes out with cost-no-object treatments. Which one calls out for rationing?
Where do the universities fit in on this? Obviously, you starve being a basic researcher in a medical school – and you have to see a bazillion patients a day as well. Faculty Jobs at MajorMed University go begging, because they pay nothing – you get your own salary out of your grant funding, chump(ette).
What to do? Obviously, work-intensive, materials-intensive, actual research is expensive. IT to the rescue! Big-Data-driven chowdering of dodgy information into speculative conclusion is a snap, and the amount and sort of work is just done in front of your computer, like Grand Theft Auto.
THESE are the fools that make the rules. And here’s where ICD-10 steps in to shine.
Did you know that the relative odds ratio for type II Diabetics with diabetic neuropathy (ICD-10-CM E11.42) to smack themselves in the testicle with a ball-peen hammer (ICD-10-CM E11.42) is 1.5 versus nondiabetics? (Confidence interval 0.9-1.8). No, didn’t know that? Well, it just came out today, in analysis using the PIROMA method (Pulled It Right Out My
Ass). Did you know that 16.57% of statistics are made up on the spot? No?
Think of it. The only think that makes the above sentence satire, and not a university publication, is that I didn’t sift through an actual database. If I did, and published it in the Journal of the American Medical Obscurity Quarterly, some mid-manager MBA twit in CMS would require that primary care doctors ask type II diabetics with neuropathy about ball-peen hammer clumsiness, and the importance of not putting one’s scrotum on the workbench. (Special mention would have to be made, of course, for transgender Women with Testicles, to account for Buzzword Bingo).
A dutiful IT clown will code it into your EMS Visit Chore List so you can code for asking the question. And you, dear provider, will ask a patient if they are hobby-challenged enough to mistake their ugly parts for Hobby Lobby purchases.
This is how bad ideas are made, and how they wind up in your lap, figuratively. Next, some medical supply rocketscientologist will start selling cups for $300 (Medicare pays), and OSHA will mandate access to employee’s medical records to determine if they qualify for cups. (Goaltenders, baseball catchers, etc.)
Tomorrow, let’s look at the New England Journal of Medicine’s embarrassing article on Peer-Reviewed Fraud.