You Get What You Pay For

The willingness to fix quickly and creatively is personified by those of us in healthcare technology support. We get the device working and maybe fill out the paperwork, if we have time.

Politicians and healthcare “experts” who probably have never worked in healthcare continually will complain about how technology increases the cost of healthcare in the United States. Yes, healthcare is expensive, but it also is the best in the world and quality costs money.

The same people who bemoan the cost of a CT scanner probably drive one of those suburban assault vehicles, the ones that cost more than $35,000. They would never think of giving up their luxury, but they don’t want to pay for healthcare that will keep them alive long after their assault vehicle has been recycled into bigger assault vehicles.

I recently needed a chest X-ray for pneumonia and was delayed because the “machine was down.” After waiting about an hour, I asked what was wrong with the X-ray unit. I was told it wasn’t the machine, but the computer system for patient registration that was down and it was against hospital policy to do any exams if the system was down. Being a graduate of the Louie DePalma school of charm, I immediately headed for the administrator’s office and let him know what I thought of his policy and asked if he had ever heard of paper and pencil. Over his desk was a plaque saying “The patient comes first.” It was a nice finishing point to our discussion.

Being fortunate or stupid enough to travel around the world working in hospitals, several things have become very clear to me. As Stephen Ambrose wrote in his book, Citizen Soldiers, we in the U.S. will fix something broken or damaged quickly and creatively. This set us apart from other armies during the Second World War.

The willingness to fix quickly and creatively is personified by those of us in healthcare technology support. If it is broken, we fix it. If we can’t fix it, we strip it for parts to fix something else. We get the device working and maybe fill out the paperwork, if we have time. Our goal is helping people.

When physicians from other countries come to the U.S., they are amazed by the vast selection of working devices. For once, they don’t have to worry if the equipment will work. It does, 99.9 percent of the time. This is a major shock to physicians who must deal with partially working devices or do without. We know we can expect e-mails from them asking for help in fixing equipment or finding parts. Many have asked whether training programs could be set up to teach their citizens how to repair medical devices. Training is not the problem; it is the salary that can be offered to these people after they get the knowledge.

I trained a person in a South American country to do basic repairs on mechanical and simple electronic devices. This person was paid $79 per month by the hospital to work 44 hours per week. After a few months, he left and opened his own “fix-it shop.” He is now driving a good car and has four people working for him. People can be trained to fix equipment anywhere in the world, but unless they can make a living wage working on medical devices, they will switch to something else.

So, the next time you hear a politician or “expert” complain about the cost of technology in healthcare, suggest that they move to another country and see how the technology we support makes their lives so much better.

By the way, someone once proposed tar and feathering these doom-sayers, but being a good engineer, I investigated the process. It would require some 15 permits from federal, state and local EPA authorities just to get the tar and heat it up. Then we would have to deal with the animal rights people about the feathers, so it probably isn’t worth it.

Veteran clinical engineer and 24×7 contributing editor David Harrington is the Director of Special Projects for Technology in Medicine, Inc., of Milford, Mass.