How is the Technology Abused?

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Abused in the sense that, it's mission creep, it's indication creep. In other countries, I was used to if you want to lower your cholesterol, move to Canada. For years they even treat cholesterol levels at the same level, it wasn't cause for medication at the same level as other places.

And there have been studies than survey based studies then worry, if you give a doctor of countries, clinical vignette say, what would you do in your community for a patient like this? Would you do A, B, C, D, we're much more likely in the U.S. to treat at a certain threshold of clinical indications, than they are in other countries.

I am not saying something in some cases it might be a good thing. But I think the general trend has been do more, rather than do less, and I think what we're seeing encouragingly is both the recognition amongst the physician community. Good example being this choosing wisely campaign, where colleagues are being encouraged by their medical society leaders to be much more judicious and prudent in their use and recommendations of certain things where there's little evidence that they would work in those circumstances.

So, I'm encouraged by that. I'm also encouraged that the ventured capital community has got the message. I live in Menlo Park which is ground zero of ventured capital in America. And my buddies are in that business tell me, we're not funding anything now unless it's better first or cheaper.

Not the old paradigm of anything that was marginally improving, or seem to have a plausible clinical effect would get money, that's changing very rapidly I think.