When will doctors find it acceptable to deny medical services?

Will there ever be a scenario where doctors will accept a third-party entity restricting care to patients?

Pauline Chen talks about comparative effectiveness research, and finds that, when recommendations are transparent and based on solid evidence, some doctors will accept this more regulated paradigm.

Dr. Chen is completely right when she observes that there is a “sense that some of [a health insurer’s] decisions are based not on well-researched recommendations but on interests, agreements and circumstances that have little or nothing to do with good care.”

In her field of transplant surgery, which she calls “one of the most successfully regulated medical fields in this country,” every surgeon makes medical decisions based on “transparency, consistency and evidence-based research,” and indeed, “all transplant doctors and patients know where their third party stands.”

The hope is that comparative effectiveness research can bring that same level of authority and transparency to other fields of medicine, because I would rather have guidelines based on solid research telling me “no,” rather than the often bewildering decisions of a faceless Medicare or health insurer bureaucrat.

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