I, like all of our Congressional representatives back home, wasn’t able to read all 1,000 (and some) pages of the stimulus bill that was just passed so I missed a lot of details. I was impressed to learn that evidence-based medicine will be getting a boost. I never even knew this issue existed until my first job in DC at the National Academies of Science where a colleague of mine was working on a study looking at the lack of evidence-based procedures in medicine.
Until then, I kind of assumed that doctors prescribed a certain treatment because it is the best treatment for the patient. It turns out, there is very little information on which treatments are best for almost any procedure because there has been little to no funding to cross compare treatments. You can find information on how effective one particular technique is on a set of patients, but you can’t evaluate how much better the outcomes are compared to a completely different protocol. In some cases ineffective or overly invasive treatments can create even more problems for patients.
I know, from personal experience, sometimes surgeries are recommended for problems that can be resolved much more simply in some instances (shoulder surgery and gall bladder surgery – to name two that I have experience with). I am not saying that doctors try to hide therapies from patients – I don’t buy into conspiracies because I know too many good doctors and researchers. I do think that doctors themselves have limited information on alternative treatments because they have learned from people who are really good at doing what they do and haven’t distracted themselves with alternatives. Plus, like I said, the studies just don’t exist for the most part because no one is paying for them. If, for example, I need my shattered wrist put back together (that was a bad year), I want the woman who knows nothing more than how to put wrists back together really, really, really well (hopefully that one will be on call when I land in the emergency room).
In my own experience with a shoulder injury (I have had to see a lot of doctors in my life – head, wrist, shoulders, neck, sternum…….) I also found the lack of information on less-invasive therapies a bit frustrating. The specialist I went to for a shoulder injury kind of laughed at me and bet that the physical therapy that I requested would fail – he said, “I’ll see you in six months for the surgery.” He begrudgingly gave me a referral so my insurance would cover it, but I had to push for it and endure a bit of ridicule. The only reason I even thought about alternatives to surgery was because of some knowledgeable therapists I met through the yoga community. If I didn’t know those people, I would not have had the confidence to seek out alternatives. When I came back six months later with a happy, healthy shoulder, the doctor was impressed, but one shouldn’t have to push as hard as I did to get referral for the cheaper, and possibly better, treatment.
I think this part of the stimulus package is a great long term investment to help in the larger problem with health care expenses – not to mention that is may save lives and improve the quality of life for many patients. The implementation will be a long, sticky process, but at least the funding will be there to get the ball rolling on a long overdue issue in health care.
Just thought I’d share……. I get all riled up about health care stuff.