Minimally invasive therapy: the French case study.
The diffusion in France of the 10 selected technologies is quite different, depending on the technology. Some are 'ancient', widely diffused and stabilized techniques, such as arthroscopy for knee surgery and lithotripsy for bladder stones. Others are very new but quickly disseminating technologies, such as laparoscopic cholecystectomy, and others, especially those based on lasers, have only a restricted diffusion related in some cases to a lasting skepticism of most physicians. It is therefore not possible to draw a common sketch that would apply to 'minimally invasive surgery in France' as a whole. Nevertheless, it is possible to stress some common points which characterize the dissemination of innovation in the French health care system since the 1980s. These include the lack of methods available to health authorities to control medical innovation; the organizational and financial constraints on health care institutions, restricting their ability to adapt to changing circumstances; a limited judicial response in the face of potentially dangerous technologies; the high degree of freedom that medical practitioners have in adopting innovations; the weakness of French industry; and the important and sometimes destructive role the media play in diffusion of health care innovations.