Here are some responses to last week’s NY Times op-ed suggesting that a comparative effectiveness institute be considered.
Most of the resistance comes from the fact that medicine is infinitely more complex and variable than the current tools of empirical data can resolve:
The number of variables in medical care (patient and treatment variability, co-morbid conditions) and degree of subjective interpretation (severity of illness) is far greater than in baseball.
That’s true. No study can incorporate the myriad of patient conditions that doctors routinely face.
Costs of such an idea also present an obstacle:
More money for evidence-based research is not the answer and is quite an irresponsible request in these precarious economic times.
Probably goes a bit too far, as I don’t think the suggestion was irresponsible at all.
I think basic comparative effectiveness needs to happen, if only to place more gravitas on medical evidence.
Without knowing whether treatment truly works, or if diagnostic tests are really necessary, the current trend of practice variation will continue to balloon health care spending.
Related posts:
- One doctor’s unnecessary procedure is another physician’s mortgage payment
- ACP: Putting effectiveness into the health care equation: Rational or rationing?
- We need comparative effectiveness research, or, I agree with Paul Krugman for the first time ever
- Multimorbidity, and why it’s difficult to care for complex medical patients
- Will patients or doctors be the biggest obstacle impeding health care reform?
- Do doctors already have a source of comparative effectiveness research?
- When will doctors find it acceptable to deny medical services?
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