ProvidersOccam’s Razor

Countless people have seen the shocking footage of Alex Wubbels, a nurse at University Hospital in Salt Lake City, being manhandled and led off in handcuffs by a Salt Lake City police detective last summer when she declined to let the officer draw blood from an unconscious patient. She ultimately reached a $500,000 settlement over the incident with the city and the University of Utah, which owns the hospital.

Liver cancer is the deadly exception. Overall, U.S. cancer death rates have been on a slow, steady decline for decades. But not for liver cancer. Deaths have been increasing by 2.8% annually for men and 2.2% for women, according to an analysis of federal data published in 2016 in the journal Cancer. Nearly 41,000 Americans are diagnosed with liver cancer each year. Fewer than one in five (17.6%) will be alive five years later.

The health care industry has a tendency to adopt whatever is new—the shiny thing that seems to address the intractable challenge of providing better care at a lower cost. At the same time, the industry is reluctant to question whether the proposed new service meets the needs of consumers—with consumers defined as patients, not the providers who take care of them. If patients are identified as the consumers, as they should be, that leads to a matryoshka nesting doll set of questions.