An Op Ed in today's New York Times by Billy Beane, Newt Gingrich and John Kerry equates health care with baseball.
Although health care is somewhat different than baseball, their point is well taken. Establishing an institute of evidence-based medicine would be a step in the right direction to help provide efficient, quality care for patients. However, many other steps will need to be taken as well.
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Upon information and belief, evidence-based medicine is where the health care provider applies statistically significant and relevant evidence acquired through quality and valid clinical trials utilizing the scientific method. The health care providers assess the risks and benefits of how they choose to treat or not to treat their patients. This paradigm of a practicing health care provider is to better predict the outcomes of their treatment of their patients. Such providers recognize the need for quality in medicine and place tremendous value on their patients' lives. This paradigm of restoring the health of others protects public health.
There are three areas of evidence-based medicine:
1. Treat patients according to what is reasonable and necessary based on the evidence that exists regarding the treatment options health care providers select.2. Health care providers review this evidence in order to judge and assess the best treatment for their patients.3. Recognize that evidence-based medicine is in fact a movement that emphasizes the usefulness of this method to practice medicine.
Two types of evidence-based medicine:
1. Evidence-based guidelines- Policies and regulations are produced to ensure optimal health care.
2. Evidence-based individual decision making- This is how restoring the health of others is practiced by the health care provider.
This is the preferred way to practice medicine instead of medical guidelines, which are created from a combination of clinical studies in which conclusions are drawn to reflect national standards of care for a particular disease state. Guidelines were implemented during the 1980s. At times, these guidelines are privately sponsored, which makes them unreliable due to bias and without independent systematic review or quality considerations by others. Unlike evidence-based medicine, guidelines can have major flaws and inaccuracies due to toxic factors used to create such guidelines. In fact, most doctors do not follow medical guidelines, yet are rewarded by programs such as Medicare if they do follow medical guidelines that are established.
Dan Abshear
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