The Cascade Effect in Medicine
The cascade effect has been identified in many casual scenarios such as when individuals pick a restaurant to eat at or purchase a book to read. However, it is also relevant in professional settings. The cascade effect has had a prominent role in the use of new medical technology and diagnosing patients. Healthcare professionals can often be swayed into purchasing equipment that they may not need or prescribing treatments their patients do no require.
Professionals have tended to “equate new medical technology with better-quality health care, assuming that newer is better.” This mindset has led to the purchase of equipment that may not necessarily have significant advantages over existing equipment. The process in which the new technology can be integrated into a practice or its potential benefits are emphasized, but often times “their use in routine care [prove] futile or even harmful. ” The idea that a new equipment is better may have begun with one doctor who found benefits in the technology over his/her old equipment. However, this idea can be spread to other doctor’s who may not necessarily benefit from switching to the new equipment. But from seeing his/her peers switch over, he can be swayed into switching as well. Additionally, having a history of positive outcomes in switching can sway the actual benefits in future purchases.
The prescription cascade is another way in which the cascade effect has a role in medicine. Shortly after a patient begins a treatment, new symptoms can develop and cause the patient to grow anxious. Doctors have tended to react to their patient’s anxiety and be blind sighted to the true root of the symptoms. If they focus more on the patient’s anxiety, they will often be too quick to prescribe another treatment when altering the initial treatment could suffice. Surgeries are a form of treatment that are often overused and it has been found that “at least as many deaths could have been prevented by reducing surgical rates to the U.S. average as by improving the technical quality of surgery. ”
Another issue related to the cascade effect in medicine lays in the assumptions doctors make. One common mistake is the failure in a doctor to accept the likelihood of false-positive results. It has been found that doctors often fail to identify false-positive results and instead they look for uncommon conditions. This is a deeply rooted belief that is difficult to change and it shows the dramatic effects the cascade effect can have. Additionally, doctors can often be “prompted to undertake screening tests in asymptomatic patients whom they perceive to have a high risk of a serious disease.” Smokers are common victims to unnecessary screening, but “randomized trials have failed to show any benefit for aggressive lung cancer screening.” The idea that smokers are at the greatest risk for lung cancer is understandable, but may be over-emphasized. The stigma has resulted in unnecessary screening and testing of smokers when they did not show any initial signs of the disease.
The cascade effect can be found everywhere and the outcomes can vary in magnitude that may or may not be life atlering. Additional ways in which the cascade effect can be found in medicine can be found in the article: http://xray.ufl.edu/files/2010/03/Oct-09-1.pdf