What happened to stainless steel instruments? Couldn’t you develop a way to make a majority of the instrument sterile, while making the business end disposable?
The conspiracy theorist inside me wants to think that hospitals some how got manufacturers to design one-time-use products so that they can turn around and “sell” them to the person getting surgery. Insurance then covers it, and costs continue to go through the roof.
Reimbursement is based on the DRG (diagnosis-related group). For example, this instrument can be used for removing a gall bladder, possibly the most common minimally evasive procedure. The hospital/physician gets reimbursed on the procedure (the DRG), not what they used in the procedure.
As for sterilization, disposables like this are generally sold on cost. The reusable instrument has a higher up front cost plus the cost of sterilization. Amortisize that cost and you are likely to find the disposable is cheaper. Cheaper is much more important in healthcare these days than green.
Also, there is a higher risk with complicated instruments like this for not getting fully sterilized and infection can easily cost in the upper 5 figures, low six figures. Combine that with a growing list of never-events (“complications” in the hospital that should never happen) that don’t get reimbursement, disposables are even more attractive. For example, the disposable company may have clinical data showing infection rates are lower with their instrument over the reusable instrument. The hospital may have to pay for a patient’s infection.
As for solutions, make the disposable as lean and mean as possible. Durability is a small issue. Use materials and manufacturing processes that have a smaller footprint. Use clinical data to show using the disposable has better outcomes and uses less materials in the long run (the amount of time, materials and energy to fight a blood stream infection is staggering).
In my experience there are usually very sound reasons why medical products are single-use, reposable, or reusable. The scalpel is a good example of a product that was once nearly 100% reusable and is now more often disposable. It is a complicated analysis but when overall carbon foot-print is analyzed (materials, manufacturing, sterilization-energy use, water use, chemical creation and treatment etc) it is sometimes the case that disposable wins over reusable. There are many exceptions. And there are many ways for the medical community to be act more sustainably. But I think there are also even easier and more obvious places to look to make a difference if we were to be serious about being more “green”; NASCAR comes to mind, as one example.
I would miss F1 and NASCAR too but those guys are pretty smart and should be able to figure out a way to run their business on renewable resources. It would require changes but sooner or later that is going to happen anyway.
To follow the tangent discussion about NASCAR, I wanted to mention how valuable every racing series have been to the development of new technology. The overall appearence may be that NASCAR, F1 etc. are not very green, and realisticly speaking driving in circles does nothing. I’m pretty sure that going to the moon didn’t really accomplish much either, but the value of the technology we got from that endeavor is enormous. It is much the same way with racing, while most of it does not seem to relate directly to our lives, the discoveries made in aerodynamics, composites, safety, tires, and yes even fuel efficiency have all trickled down to our everyday objects and cars and had very positive impacts.
I don’t mean to rant but overall when people think about “green” they focus on specifics and rarely look at the big picture and the overall impacts. This issue applies to every single type of product.
It is a really good point. The various racing industries have made substantial contributions to safety, performance and even increasing MPG. It would be great to see them take a leadership role in sustainable fuels as well.