BLOG: Why we defend the status quo

ByJohn A. Hovanesian, MD, FACS

When I was in high school, my mother — a gifted cook — vigorously resisted buying a microwave oven. “I don’t need that box taking up my counter space when I already have a stove,” she would say. The family, having heard about microwave ovens from friends for nearly a decade, finally bought her one against her wishes. Once she started using it, my mom fell in love with the microwave and used it for more and more recipes. One time she tried using it to bake a cake. The failed experiment generated great family stories and helped her realize the limitations of the new device without diminishing her admiration of its benefits.

My mom was not alone in resisting change to new technology. Fifteen years ago, if I approached you with a small, black, hand-held rectangle and told you I wanted to sell it to you for $1,000, you would probably think I was crazy. If I explained that this new device called an “iPhone” could help you do email on the run and it would change your life, you’d tell me that you don’t need it because you already have a computer. If I mentioned the availability of weather and traffic updates, you might say the radio station broadcasts those every 10 minutes. If you’d never heard of a smartphone before, it would probably take at least several minutes of conversation to pique your interest. You probably would still not buy one of these devices until you had reached a certain critical mass of exposure, watching friends, seeing ads and thinking about how it could help you. Once you did, you would realize you had a “latent need” for this device. Once you recognized your latent need, you would not only want one, but you’d happily pay $1,000 for it and wonder how you ever lived without it.

So it goes with the adoption of many new technologies. We don’t realize our latent need until we witness firsthand the benefits of the disruptive new offering.

We doctors are among the most likely to defend the status quo and resist adopting new technology. We rely on the dogma of our training to guide treatment decisions, and we suspect ulterior motives of the drug and device industry when it brings forth new products. Plagued by indecision about a new offering, we ask for more studies to justify its use when FDA registration studies have already amply demonstrated both safety and effectiveness.

This reaction is both normal and helpful, within limits. Healthy skepticism prevents dangerous products from gaining too-fast market acceptance. But resistance to change can also harm valuable technologies before they prove their benefits. Arguably this has already happened with corneal inlays, whose clinical results are far better than their commercial success would suggest.

As physicians, we need to be receptive to looking past dogma and trying new technologies if we want new technologies to be developed. Drug and device companies and their investors simply can’t overcome the barriers to bringing new treatments to market if the market resists their arrival. Listen to the podium presentations, read the journal articles, and spend a little time with the company representative to learn more. Try the new drug or device, and spend a little time figuring out how to make it benefit your patients when it’s not obvious.

We doctors will probably never be the first one in the neighborhood to get a microwave, but we shouldn’t be the last either. Practicing medicine wisely means pioneering with wisdom, curiosity and willingness to challenge the status quo.

Disclosure: Hovanesian reports no relevant financial disclosures.