Intended for healthcare professionals

Rapid response to:

Analysis And Comment Surgery

Adoption of new surgical technology

BMJ 2006; 332 doi: (Published 12 January 2006) Cite this as: BMJ 2006;332:112

Rapid Response:

Adoption of new surgical technology: Putting the cart before the horse


The piece by Dr Wilson on the adoption of new surgical technology was
extremely interesting and raised an aspect of innovation that is not often
thought about- the psyche of the medical team adopting new technology.
However, some points are worthy of note here. The author betrays an
underlying assumption that all innovators are the swashbuckling type and
are keen to try on the latest fashion on the block. This is hardly the
case nowadays. An unhealthy emphasis on safe rather than efficient
surgical practice and target-driven patient care have served to ensure
that all new technology is ‘guilty until proven innocent’ and that all
innovation is looked at with a great deal of suspicion.

Some initial risk-taking and openness to new technology is essential
in order to determine efficacy and cost-effectiveness in a prescribed
format at a later stage. In this light, it would be interesting to compare
the time it takes to bring a new technique to the clinic now as opposed to
50 years ago. I would guess that the 20% critical mass that was quoted in
the article would have been reached much sooner in an earlier era.

In addition, it must also be remembered that successful technology is
subject to greater scrutiny at a later stage than those that are abandoned
very early on by the innovators themselves, therefore introducing a
selection bias.

This being said, I would like to commend the author on his
observations on this very interesting angle and thank the journal for
publishing analyses of this quality.

Vinay P Rao

Disclaimer: The views expressed in this letter are the personal
opinion of the author rather than that of the Mayo Clinic.

Competing interests:
None declared

Competing interests: No competing interests

17 January 2006
Vinay P Rao
Research Fellow
Mayo Clinic, Rochester USA 55905