I love listening to Warren Buffet talk. The Oracle of Omaha is a repository of wonderful business and investing tips. I especially love his focus on value. He is widely regarded as one of the greatest value investors who has ever lived. If you listen closely, you'll note a peculiar thing that he repeatedly says. The key to investing has nothing to do with brains.
Buffet constantly harps on the ability to think clearly, not get too high or too low, and never follow the crowd. He uses his catchphrase, "circle of competence," to describe how investors should spend a lot of time determining what they know well and never venturing outside of it. He maintains that any one can invest well if they simply stick to what they understand, no matter how large or small that "circle of competence" is.
Many people are simply incapable of doing this. The attraction of following the crowd or taking on too much risk for the mere hope of improving returns (see nearly all actively managed hedge funds) overcomes their sensibilities, and they find themselves doing the same thing that everyone else is doing. This results in the same results that everyone else gets.
Physicians are no different. In fact, as a group, we are a case study for why having any amount of brains can actually be far more dangerous than helpful. As one of my mentors in residency said, "Some of the most intelligent physicians you will ever meet can't make two plus two equal four." Quite simply, common sense can oftentimes escape those that are considered the most intelligent.
The medical field is in the beginning stages of a transformation. Value is the new buzzword and the very nature of how transactions are made in healthcare will be changing from a fee for service, pay when you get seen environment to a value based, pay for results environment. Many physicians do not grasp this and have no idea the type of change this will have on their daily medical practice. Today, we discuss just one small part of this change, colonoscopies.
Every one that has hit the magical age of fifty and been to a doctor has gotten to have the lovely conversation with their doctor of screening for colon cancer. Millions of Americans have then gone from their physician's office to the closest facility and gotten a colonoscopy, all in the name of prevention and wellness. Unfortunately, many people do so without realizing their options.
What would you say if I could replace that unpleasant, costly, and risk laden procedure with a simple at home, yearly test? As a matter of fact, I can. A fecal occult blood test looking for blood in the stool can be done in the privacy of one's home and, when performed yearly, give the exact same results as a colonoscopy.
In fact, America is one of the few places in the world where a colonoscopy is the first thing offered for colon cancer screening. The idea is considered laughable in Europe where fecal occult blood tests are even done every two years and usually not starting until age 60. Why are the Americans pouring all this money into an expensive, risky test that can be reproduced with a simple stool sample collected at home? It's ludicrous, and it's another example of how Warren Buffet would simply shake his head at us.
So this is a shout out to all of my gastroenterology friends. Save your money now. When insurance companies and Medicare/Medicaid change to a value based system, you can bet that regular colonoscopies will be on the chopping block. No one is going to pay for a procedure that can be replaced with a stool sample. That's one test that is most definitely worth a crap.
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