On Tom, Katie and Prudence

Medical ultrasound has long been known to be both safe and effective in diagnosing many different kinds of diseases. To date, there are no known side effects of ultrasound imaging. However, with the new breed of equipment that are manufactured today, which produces more ultrasound power and which noticeably generates more heat, there are concerns that there may be side effects that may be discovered only in the future. Thus prudent use of the technology is advised by many international medical societies concerned with ultrasound.

The safety group of the British Medical Ultrasound Society (BMUS), one of the well known societies that studies ultrasound instrumentation, has an official statement on the safety of ultrasound, which recommends prudence on use of the technology:

There is no evidence that diagnostic ultrasound has produced any harm to patients in the four decades that it has been in use. However, the acoustic output of modern equipment is generally much greater than that of the early equipment and, in view of the continuing progress in equipment design and applications, outputs may be expected to continue to be subject to change. Also, investigations into the possibility of subtle or transient effects are still at an early stage. Consequently diagnostic ultrasound can olyn be considered safe if used prudently.

Meanwhile, the American Institure of Ultrasound in Medicine (AIUM) also espoused prudence on the use of the ultrasound in their statement:

There are no confirmed biological effects on patients or instrument operators caused by exposures from present diagnostic ultrasound equipment. Although the possibility exists that such biological effects may be identified in the future, current data indicate that the benefits to patients of the prudent use of diagnostic ultrasound outweight the risks, if any, that may be present.

Which means that ultrasound is indeed safe, or at least that is what we know so far...

But what does that has got to do with Tom Cruise?

Well, just today, I read from the news (yahoo movie news) that Mr. Cruise bought his own ultrasound (the news clip used the word sonogram) machine to be able to see his own baby inside the tummy of his fiance Ms. Katie Holmes!

Not every family can afford one at a price tab of up to $200,000 but actor Tom Cruise says he bought a sonogram machine for his pregnant fiance Katie Holmes so that they can monitor the development of their child.

The news clip didn't say though what kind of ultrasound machine Mr. Cruise bought and perhaps the same is mistaken to say that the system will cost between $150,000 to $200,000 (An ultrasound to be used only to see the baby will not cost that much, even if it the most expensive model and with 3D/4D feature). It would be interesting to know what brand he purchased (most probably an US brand).

But what is Mr. Cruise planning to do with his machine? Would he be looking at his baby every now and then that he needed to have his own equipment? If that is the case, Mr. Cruise is yet to meet Ms. Prudence.

I just hope that Tom Cruise would read the BMUS' and AIUM's statements first before he uses his ultrasound like an ordinary camera. I also hope that everything'll turn out well especially for the baby.

Philippine Healthcare in Crisis?

There is this news in the papers today that said that Philippines' healthcare is now in the verge of collapse. This is because of the apparent flight of doctors and other healthcare personnel to other countries for better paying jobs. With more than 200 times better pay in say USA or UK, and with the political undertainties here and all, the question is: who would like to stay in the Philippines?

Jossel Ebesate, general secretary of the Alliance of Health Workers, said the situation had become so bad that the country's healthcare system would collapse within the next two to three years.

Brain Drain, including in the healthcare sector, is said to have been going on since the '70s. From then up to now, there was no solution made to prevent it. Doomsday scenarios have already been painted many times over from long ago, but we are still here, and our healthcare industry is still growing. So, I do not believe the system will collapse in 2 - 3 years. What I believe in, though, is that the quality of healthcare is going, and will still go, down.

This "brain drain" has in fact also affected us. As a provider of healthcare equipment, we need medical technicians as applications specialists (Apps) to help us demonstrate our products and train our customers how to use them. Since 2000, we've had three 2D-Echocardiography Apps. The first one who worked with us on part time basis, Charles, who by the way was also my colleague way back GE times, is now in Saudi Arabia. The next one, Vin, who also worked with us on part time basis while waiting for his documents to go abroad, is now in Canada with wife and kids. Vin's wife is a vascular technician, another healthcare practitioner. The third Apps we've had, Regi, who worked with us full time (for almost 2 years?), is now in UK. Now, our Apps, Jane, although still working for us full time, is trying to complete her papers to go to the USA. Although we prefer that they stay with us, and we think that the salaries and benefits we provide are among the best locally, there is just nothing we can do to stop them from going abroad (at this time). We just cannot compete against these UK, US, Canada or Saudi employers who pays talents by the hour at a rate approaching to what we can give in a week!

So I guess we have to live with it. But there is something that we do that somehow helps the country avert what others say is the impending healthcare crisis. MEDEV has developed and now provides training to Cardio-technicians (our customers) on how to perform cardio-diagnostic procedures. Regi actually started and developed the training program and Jane now currently and regularly gives it to our customers who need it. To date, we have a number of "graduates" whom we taught from scratch but now can perform 2D-Echocardiography exams that are at least acceptable to cardiologists (2D-Echocardiography readers). We can also provide basic ECG training and performance of ECG procedures (including stress and holter ECG).

Of course, I still dream of the day when no one needs to go abroad to work. At MEDEV, we will strive to do that for our employees.

MyLab

Our supplier, ESAOTE, is a dedicated (well, almost) ultrasound company. Yes, they still produce ECG and MRI machines, but the bulk of their business and research are in ultrasound.

I believe that they have the widest ultrasound product range in the market today. They have the smallest and lightest ultrasound, such as the Tringa, and top of the line systems, such as the Technos. They seem not to be content with that though, for now they are adding the MyLab range of ultrasound equipment to their product basket.

The Mylab range consists of the Mylab 15, Mylab 25, Mylab 30CV, Mylab 50, Mylab 50CV, and just recently, the Mylab 70. I know at least that the Mylab 20 will also be released soon. That makes it 7 models of Mylabs. Adding that to the previous models, Tringa, Piccolo, Falco, Aquila, Corvus, PicusBW, Picus/Pro, Caris, Caris Plus, Megas CVX, Megas GPX, AU5, Esatune, Technos Partner, and Technos MPX/MP makes more than 20 distinct ultrasound models (23 in fact). If you note that each model has dozens of different configuration and accessories, that adds up to hundreds of different specific markets to address.

Now, you can just imagine how many different brochures our sales people keep!

And Now, 4D from ESAOTE

As said in my previous post, many customers are asking for 4D ultrasound, even though such equipment does not have any proven clinical purpose. After GE, Philips and Siemens, Esaote, who earlier seems not bent on joining the bandwagon, gave in to pressure and released their own version of 4D Ultrasound (Picus Just4D).

Well, maybe, Esaote's move is not just mere "giving-in to pressure", rather it is more of "listening to the ground". But with GE and Philips so entrenched in the market already with their Voluson 730 4D (GE) and HDI4000 Live 3D (Philips) system, is there enough room for Esaote?

That is what we, as Esaote's exclusive dealer, would have to find out.