Michael Lewis’ Moneyball is an excellent book, and I regularly use its baseball insight when I play historical fantasy baseball over at Diamond Mind Online.
A NY Times op-ed written by the primary Moneyball disciple Billy Beane, along with Newt Gingrich and John Kerry, wants medicine to endorse more objective data when making clinical decisions.
They’re essentially proposing a comparative effectiveness institute, where a national body can make empirical recommendations of what works and what doesn’t, based on data from studies.
I’m in agreement with the concept. However, my biggest concern is how patients will accept it. With the mentality of “more medicine is better care” so entrenched in the American patient, how will they accept it when an MRI for back pain, or an angioplasty for stable coronary artery disease is denied?
Imagine the outcry when the latest cancer therapy gets denied.
Embracing the numbers is nice, but a significant effort to educate the public on the ramifications of evidence-based medicine is equally important.
Related posts:
- Moneyball medicine
- Health care and baseball
- Who should avoid medicine?
- Sicko and hail-Mary medicine
- Why health reform is going to be difficult, and the trouble with saying no to American patients
- Should severe birth injuries be pulled out of the court system, and can defensive medicine be good?
- Dr. SSS: The two most expensive words in medicine
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Most patients eventually won’t have a choice whether or not to accept rationing. We’re running out of money and something will have to give.
This seems like a reasonable effort but I doubt they’ll be able to get valid stats for situations I encounter daily in family medicine. One reason statheads like baseball is that it’s not as difficult to isolate individual contributions, at least on offense. The complexity of the mixture of various ailments makes baseball stats look simple.
Just send those difficult patients for whom the protocol is unsatisfactory to the Comparative Effective Institute for treatment and make your life easier. Either their brilliance is as superior as they think and they will find the right solution or they will be humbled and be more circumspect about issuing edicts. The former is a win for the patient, the latter a win for the profession and patients, and you win regardless.
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