Patients often reject evidence based medicine

A recent study from Health Affairs found that people are skeptical about evidence-based care.

I’ll admit, my first reaction was, “they needed a study for that?”

Regular readers of this blog know that I think patients need to share the responsibility with doctors when it comes to embracing evidence-based medicine.

According to the study,

… participants also believed that any new treatment is improved treatment. This attitude may help explain the survey finding that only 47 percent of respondents agreed that it is reasonable to pay less out of pocket for the most effective treatments and drugs. Linking cost sharing to clinical effectiveness may be perceived as restricting treatment options, particularly for unproven therapies.

This corroborates conventional public wisdom that more care is better medicine — which is not always to case. The concepts of false positives and complications stemming from increasingly invasive studies ring hollow to most.

Health reformers who advocate using evidence and comparative effectiveness studies to control costs and reduce waste are going to meet a resistant consumer:

Given the widespread view that lower-cost care is clinically inferior, it is perhaps not surprising that focus-group participants found it inappropriate to discuss with their physician the costs of different treatments, believing that decisions about medical treatments should be based on individual needs alone. A number of participants reacted negatively to the term “good value for the money,” equating it with bargain-basement pricing and low quality.

The proposed solution, of course, is to better educate patients. But given how entrenched these beliefs are, it’s going to be a long, slow process.

Hopefully the Health Affairs piece will force health reformers to acknowledge that patients themselves need to play a shared role in accepting evidence-based medical decisions, instead of placing the responsibility solely at the feet of doctors.

Otherwise, all the comparative effectiveness data in the world will only fall upon deaf ears.