Innovation or exploitation? The hidden costs of technological advancements in healthcare

In the Philippines, certain medical institutions heavily promote their use of cuttingedge technologies like robotic surgeries. These innovations, often marketed as superior care, at tract patients seeking the latest treatments. However, while technology has its place in modern medicine, the promotion of such procedures may not always align with patient welfare — especially when financial incentives come into play.

Promoting living-related kidney transplantation: Compassion or marketing tool?

Living-related kidney transplantation is undeniably life-changing, offering recipients a second chance and demonstrating profound acts of compassion by donors. It is a noble and selfless act that should be honored without reservations. However, such stories are increasingly leveraged to market procedures like robotic-assisted kidney transplantation (RAKT). While living donations should absolutely be promoted, they should not be misused to spotlight technologies without proper context or need.

RAKT may offer benefits in select cases – specifically those involving obesity, complex anatomy, or health conditions that make minimally invasive surgery preferable. However, most kidney transplant recipients do not fit these criteria, and outcomes for RAKT and traditional surgery are largely the same. A study from the Clinical Kidney Journal highlights that RAKT has similar long-term outcomes (graft survival and patient survival) to traditional open surgery.

While RAKT can reduce incision size and shorten hospital stays by a day or two, this comes with trade-offs. Robotic surgeries typically take longer to perform, increasing exposure to anesthesia and associated risks, such as respiratory issues, blood clots and infections. For most patients, traditional transplantation – refined over decades – remains the safer, more efficient choice.

The cost difference is significant. Robotic procedures can be two to three times more expensive than traditional surgeries. The Clinical Kidney Journal study emphasizes that while robotic techniques may seem appealing, the financial burden placed on patients is often not justified by these minor improvements in recovery time.

Marketing, “not-for-profit” irony and ethical concerns

The promotion of robotic surgeries highlights a disconnect between medical necessity and marketing strategies. Hospitals position robotic procedures as the superior choice, suggesting that simpler, less expensive options are inferior. This can pressure patients – often already overwhelmed by their condition – to opt for pricier treatments even when traditional surgeries would be just as effective.

Promotional campaigns often lump robotic procedures together, creating the illusion of universal benefits. For example, while robotic prostate surgery may show advantages, robotic kidney transplantation does not demonstrate the same level of benefit. Patients may be persuaded into choosing an unnecessarily expensive and complex surgery, even when publications such as those in Nature Reviews Urology confirm that RAKT outcomes are comparable to traditional methods.

This promotion is a new approach — leveraging emotionally charged stories of living-related donations to market RAKT as a groundbreaking option. While hospitals registered as “not-for-profit” institutions enjoy tax benefits and claim to prioritize patient welfare, this kind of marketing pushes costly, revenue-generating surgeries without fully clarifying their necessity or advantages. Such strategies blur the line between altruism and commercialism, raising questions about where the true focus lies: patient care or profit?

A hospital bearing a “virtuous” name would have done better to promote living-related kidney transplants for what they truly are – a laudable, life-changing act – rather than using it as a platform to promote an expensive technology.

Copying “leaders,” hidden risks and measuring true success

When hospitals market procedures like RAKT as revolutionary, other institutions feel the pressure to follow suit, regardless of medical necessity. In an effort to remain competitive, hospitals may invest in expensive technologies that don’t necessarily offer better outcomes. This cycle drives up costs across the healthcare system and places financial burdens on patients, many of whom may be paying for treatments that don’t provide added benefit.

Beyond the marketing, robotic surgeries carry their own risks. The Clinical Kidney Journal notes that RAKT procedures take considerably longer than traditional surgeries, which exposes patients to increased risks associated with prolonged anesthesia. These risks, such as respiratory complications and infections, are often downplayed in favor of promoting the supposed benefits of “precision” and quicker recovery.

Traditional kidney transplantation, in contrast, is a well-established and highly effective procedure with decades of evidence backing its safety and success. Surgeons perform these operations efficiently without the complexity and risks that come with robotic equipment. For most patients, traditional surgery remains the better choice, offering similar outcomes without inflated costs or increased surgical times.

Whether performed through RAKT or traditional surgery, the true measure of success lies in how long the kidney transplant lasts. While robotic surgery may lead to a slightly shorter hospital stay, the real determinants of a transplant’s success are the post-operative care, ongoing immunosuppressive therapy, and vigilant monitoring to prevent rejection. The emphasis on getting out of the hospital quickly often overshadows the bigger picture: that long-term graft function, patient lifestyle changes, and adherence to follow-up care are what ultimately determine a transplant’s success.

Transparency and patient empowerment

One of the critical aspects of RAKT is ensuring that hospitals have sufficient experience with the technology, so patients are not inadvertently part of a learning curve for a complex, costly procedure. When a hospital has only completed a handful of these procedures, patients might unknowingly pay full price for a surgery that’s still part of the hospital’s push to master the technology.

Healthcare providers have a responsibility to ensure new technologies are used for patient benefit, not for profit. Robotic surgeries should not be promoted as a default choice unless there is clear evidence they improve outcomes over traditional methods. Patients deserve transparency about the risks, costs, and alternatives to expensive procedures.

The Journal of the American Medical Association (JAMA) supports this broader narrative, showing that robotic surgeries provide minimal advantages in recovery times compared to traditional methods while significantly increasing costs and surgical risks. Hospitals should focus on patient outcomes over marketing-driven technologies.

Physicians need to discuss the benefits, risks, and costs of both robotic and traditional surgeries openly, ensuring that patients understand all options and can choose what aligns with their health needs and financial circumstances. Only through full transparency can patients make choices that are genuinely in their best interest.

Final reflections: The trend across specialties

It’s not just kidney transplantation – this trend of promoting costly technologies exists across medical specialties, from orthopedic surgeries to cardiac interventions. Patients should always question whether an expensive new procedure is truly necessary or if more traditional methods might be equally effective and safer.

The healthcare community must reflect on its priorities. The goal should be to make healthcare more accessible and equitable, ensuring that technological advancements benefit all patients - not just those who can afford premium services. Hospitals should balance innovation with responsibility, keeping patient welfare at the forefront of decision-making.

The future of healthcare in the Philippines depends on the choices we make today. By focusing on patient-centered care and ensuring that technological advancements serve the needs of all, we can create a healthcare system that truly delivers on its promise of care for all Filipinos.