(Snippets from the frontline)
Evidence-based medicine
Ignaz Semmelweis, an Austrian physician, observed in the mid-1800s hand washing prevented complications following childbirth saving thousands of women. Later in the century, research by Louis Pasteur confirmed the “germs theory” as a reason for infections.
Reliance on intuition was replaced by the “scientific method”, using research to validate observations contributing to the advancement of medicine.
Derived from this now is the term “evidence-based”, frequently used by doctors in decision-making to support a patient treatment plan. But it is not fixed. For example, aspirin, once touted to lower the chance of strokes and heart attacks is being challenged.
Research is overwhelmingly honest and reliable, but in this day and age, “evidence-based” can be misappropriated when special interests like hospitals, insurance, and pharmaceutical companies manipulate data for financial gain. The funding source for studies may be biased, statistics skewed, information misinterpreted, or figures falsified ultimately fogging “evidence-based.”
Doctors and the public must remain mindful of this possibility, especially when timely screening tests like mammograms are denied, and potential lifesaving medication or surgical treatment is rejected to augment profit.
Intuition should still be a worthy part of patient care decision-making.
Gene Uzawa Dorio, M.D.
“Don’t ever confuse what is legal with what is moral…..You’re either principled or you’re not.” Oprah Winfrey
Can’t say it better myself
WB, what might be the effect of extending a Virginia law to all states and the I.R.S. (1)? HB
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(1) “Donations of Professional Services” gives tax-credits to doctors, dentists, and lawyers giving charity-care to indigent patients.
All true. EBM means one thing under Medicare and a completely different thing under Commercial plans. Though remaining “mindful” of these areas of disagreement is good, often lack of “evidence” means a drug or therapy is not covered…mindful or not. Not critical of the comment, but it is a very troublesome situation.
On the other hand, even now, lots of docs over use antibiotics, use costly drugs where inexpensive are more appropriate, etc.
From my cynical perspective, we have met the enemy and he is us, or something to that effect. We (medicine/docs) gave up control to our profession many years ago by hiring MBA (non-doc) and allowing organized medicine (AMA, AOA, ACP, etc) “advocate for us,” often resulting in various misadventures that bring headaches to the practicing doc and lots of $$ to organized medicine. Unfortunate. wb