Is evidence-based medicine appropriate for the elderly?

Policy experts desperately want to reduce the amount of variability Medicare patients receive.

Studies have suggested that standardizing care is one approach to control health costs, and bodies like a comparative effectiveness institute would be helpful to bring evidence to the forefront of clinical care.

That may work well for a young, healthy population, but not in the elderly. Jane Brody writes an article describing the difficulties applying “cookbook medicine” to older patients. Geriatricians “must take into account the whole picture of the patient, the patient’s family and life situation,” and that introduces individual variability that evidence-based medicine seeks to eliminate.

Indeed, we should make efforts to reduce the amount of practice variability. But doing so excessively can lead to negative consequences, especially in the Medicare population.

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